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Shock
Test 2 Advanced patho
Question | Answer |
---|---|
Shock | The physiologic state characterized by a reduction of systemic tissue perfusion resulting in decreased oxygen delivery to the cells and tissues. |
Systemic Tissue perfusion | Cardiac output and systemic vascular resistance CO = HR x SV Stroke volume is related to preload, myocardial contractility and after load. Affected by vessel length, blood viscosity and vessel diameter |
Cardinal Symptoms of Shock | Hypotension: absolute SBP <90 or Relative: a decrease in SBP >40 Oliguria: vol. depletion, shunting to kidney Altered mental status: agitation, confusion, coma Cool clammy skin: vaso constriction Metabolic acidosis: lactate build up |
Prognosis of Shock | Depends on type and severity Time of onset of initial treatment Co-morbid states, development of complications Even with treatment: septic and cardiogenic >50% mortality. Untreated: fatal |
States of Shock | Preshock Shock End organ dysfunction |
Preshock | Warm shock: decreased afterload (SVR) Increased cardiac output/cardiac index Decreased blood pressure Sympathetic response |
Shock: cold shock | Decreased CO Elevated SVR Decreased perfusion Sympathetic response Hypothermia |
End Organ Dysfunction | Multiple organ dysfunction syndroms |