Beruflich Dokumente
Kultur Dokumente
I.
II.
III.
IV.
V.
Basic Principals
A. Characterized by hypoperfusion caused either by reduction in
cardiac output or effective circulating blood volume
Causes
A. Cardiogenic
B. Hypovolemic
C. Septic
Cardiogenic Shock
A. Defined
i. State where the heart has been damaged to the point where
it is unable to supply enough blood to the organs of the body
ii. Failure to pump blood causes a fall in blood pressure
iii. Organs begin to fail
B. Clinical examples
i. MI
ii. Ventricular rupture
iii. Arrythmia
iv. Cardiac tamponade
v. Pulmonary Embolism
Hypovolemic Shock
A. Defined
i. Loss of RBC mass and plasma from hemorrhage
ii. Loss of plasma volume alone due to extravascular fluid
seqesteration, or GI, urinary, and insensible losses
iii. Loss of more than 20% of blood volume result in shock
B. Pathogenesis
i. Decreased:
1. Cardiac output
2. Left ventricular end diastolic pressure
3. Mixed venous oxygen content
ii. Increased:
1. Peripheral vascular resistance
C. Clinical Features
i. Cold, clammy skin
ii. Hypotension
iii. Decreased urine output
iv. Hb level is not altered in early stages (due to equal loss of
RBC and plasma)
v. Increased anion gap: metabolic acidosis (due to increased
anaerobic glycolysis)
Septic Shock
A. Definition
i. Sepsis accompanied by hypotension that cannot be
corrected by the infusion of fluids
B. Etiology
i.
ii.
iii.
iv.
v.
VI.