9 circulatory shock.pdf - Circulatory collapse-cardiac-periferal 1 Circulatory Shock acute or subacute progressive generalized circulatory failure with

9 circulatory shock.pdf - Circulatory...

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1 Circulatory collapse: -cardiac -periferal
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Circulatory Shock acute or subacute progressive generalized circulatory failure with an abnormal microcirculation and underperfusion of vital organs. prolonged hypotension, leading to inadequate tissue perfusion Inadequate tissue perfusion can result in : -generalized cellular hypoxia (starvation) -widespread impairment of cellular metabolism -tissue damage organ failure -death 2
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Types of shock Hypovolemic shock Decreased intravascular volume resulting form loss of blood, plasma, or fluids and electrolytes Cardiogenic shock Pump failure due to myocardial damage or massive obstruction of outflow tracts Obstructive shock Distributive shock Reduction of vascular resistance form • Sepsis, Systemic inflammatory response syndrome (SIRS) • Anaphylaxis • Neurogenic 4
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Hypovolemic shock Loss of blood (hemorrhagic) External bleeding (wound to the outside or gastrointestinal) Internal bleeding (hematoma, hemothorax, hemopertitoneum) Loss of plasma Burns Exfoliative dermatitis Loss of fluids and electrolytes External (vomiting, diarrhea, excessive sweating) – Internal ( “third spacing” = pancreatitis, ascitis, bowl obstruction Excessive sweating 5
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Stages od shock Initial stage tissues are under perfused, CO, anaerobic metabolism, lactic acid is building Compensatory stage Reversible SNS activated by low CO, attempting to compensate for the decrease tissue perfusion Progressive stage falling compensatory mechanisms profound vasoconstriction from the SNS ischemia lactic acid is high metabolic acidosis, Na, K Irreversible or refractory stage cellular necrosis and Multiple Organ Dysfunction Syndrome may occur 7
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