Shock & Monitoring-1

Shock & Monitoring-1 - Shock...

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Shock Differential Diagnosis and Hemodynamic  Monitoring Andrew Watt SICU CONFERENCE
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Shock Shock is a Cardiovascular Derangement. 1. Deliver Oxygen and Metabolic Substrates 2. Remove Products of Cellular Metabolism 3. Thermoregulation Definition : A physiological state characterized by a significant,  systemic reduction in tissue perfusion, resulting in  decreased tissue oxygen delivery and insufficient  removal of cellular metabolic products, resulting in  tissue injury.
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Classification of Shock Hypovolemic Septic/Inflammatory Obstructive) Neurogenic Anaphylactic
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Clinical Markers of Shock K l k j   Brachial systolic blood pressure: <110mmHg Sinus tachycardia: >90 beats/min Respiratory rate: <7 or >29 breaths/min Urine Output: <0.5cc/kg/hr Metabolic acidemia: [HCO3]<31mEq/L or base deficit>3mEq/L Hypoxemia: 0-50yr: <90mmHg; 51-70yr: <80mmHg;  >71yo<70mmHg;  Cutaneous vasoconstriction vs. vasodilation. Mental Changes: anxiousness, agitation, indifference, lethargy,  obtundation
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Etiology & Hemodynamic Changes in Shock Etiology of shock example CVP CO SVR VO2 sat preload hypovolemic low low high low contractility cardiogenic high low high low afterload distributive
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Etiology & Hemodynamic Changes in Shock (Afterload) ETIOLOGY OF SHOCK EXAMPLE CVP CO SVR VO2 SAT AFTERLOAD DISTRIBUTIVE Hyperdynamic Septic Low/High High Low High Hypodynamic Septic Low/High Low High Low/High Neurogenic Low Low Low Low Anaphylactic Low Low Low Low
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Hypovolemic Shock Decreased preload->small ventricular end-diastolic  volumes -> inadequate cardiac generation of pressure 
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This note was uploaded on 12/24/2011 for the course STEP 1 taught by Professor Dr.aslam during the Fall '11 term at Montgomery College.

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Shock &amp;amp; Monitoring-1 - Shock...

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