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Shock

OVERVIEW

HISTORICAL PERSPECTIVE:

• There is limited historical perspective for shock.

Definition:

Shock is defined as decrease in the oxygen delivery to the cells and tissues due to either increase in oxygen demand, decrease in oxygen consumption, inadequate oxygen utilization or a combination of these processes.

Classification:

• Distributive shock
• Obstructive shock

• cardiogenic shock
• Hypovolemic shock

Causes:

• Distributive shock can be from Septic Shock, Systemic inflammatory response syndrome, endocrine, toxin and drug induced, Anaphylactic shock and Neurogenic shock.
• Obstructive shock can be mechanical, pulmonary or Vascular causes.
• Cardiogenic shock can be from cardiomyopathy, Arryhthmias or mechanical.
• Hypovolemic shock can be hemorrhagic or non -hemorrhagic.

Pathophysiology:

Characteristics of forms of shock

Types of shock	CVP	PCWP	CARDIAC OUTPUT	SYSTEMIC VASCULAR RESISTANCE
Distributive	decrease	decrease	increase	decrease
cardiogenic	increase	increase	decrease	increase
obstructive	increase	may increase or decrease	decrease	increase
hypovolemic	decrease	decrease	decrease	increase

shock

cold clammy extremities

warm bounding extremities

Low cardiac output

high cardiac output

inc JVP,crackes

Dec JVP,orthostasis

septic shock,liver failure

cardiogenic shock

hypovolemic shock

antibiotics,IV fluids

evaluate for MI

IV fluids