Shock Septic shock

Shock Septic shock - Shock Septic shock Pathophysiology of...

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Shock Septic shock Pathophysiology of Septic Shock Inflammatory mediators associated with endotoxin release due to overwhelming sepsis (usually gram-negative) cause vasodilation, intravascular coagulation and loss of circulating volume through leaky capillaries Blood pools in dilated peripheries, reducing venous return and cardiac output (but CO may be normal or high) Blood pressure (~CO x SVR) is reduced; particularly diastolic pressure, hence pulse pressure may be increased Myocardial depression and pulmonary hypertension may occur Translocation of bacteria from ischaemic gut may occur Features of Septic Shock Early – warm shock o Oxygen delivery may be adequate, but consumption may be low; SvO 2 high o Vasodilated warm peripheries with rapid capillary refill, low venous pressure o Bounding or collapsing pulse o Tachycardia may be less marked than in hypovolaemic shock o Pyrexia and rigors Late – cold shock o As for hypovolaemic shock o Myocardial depression (high venous pressure with fluid replacement)
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Shock Septic shock - Shock Septic shock Pathophysiology of...

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