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16 Cards in this Set
- Front
- Back
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Organ hypoperfusion
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Imbalance in oxygen supply & demand
↓oxygen supply Shift to anaerobic metabolism ↑ production & accumulation of lactic acid and CO2 Cellular dysfunction and death Organ dysfunction and failure |
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Signs and symptomsof shock ?Labs?
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Hypotension
Change in mental status Pallor --Labs Lactic acidosis ↑SCr ↑LFTs ↓Urine output or oliguria Thrombocytopenia |
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4 major types of shock
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4 major types of shock:
Obstructive Cardiogenic Hypovolemic Vasodilatory |
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Outflow obstruction?
Inflow obstruction? |
Outflow obstruction:
Pulmonary embolism Aortic/pulmonary valve stenosis Inflow obstruction: Pericardial effusion Tamponade |
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Cardiogenic Shock
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Inability of heart to supply adequate blood to organs
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what is Hypovolemic Shock?Types?
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Loss of circulating blood volume
Absolute Hypovolemia Relative Hypovolemia |
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Are the reasons for Absolute Hypovolemia:
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Absolute Hypovolemia
Hemorrhage Dehydration Inadequate intake Excessive outflow |
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Are the reasons for relative Hypovolemia
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Third-spacing
-Includes fluid in peritoneal, pleural and pericardial cavities, joint spaces, GI tract and CSF major is Ascites |
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Failure of the blood vessels due to vasodilation
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Vasodilatory Shock-
due to vasodilation Anaphylaxis Neurogenic shock Septic shock |
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Vasodilatory Shock due to
severe infection |
Septic shock
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Severe systemic allergyand
Immunologically mediated release of vasodilatory substances |
Anaphylaxis Shock
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Infection versus bacteremia
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vInfection
Local inflammatory response to the presence of microorganisms Bacteremia Type of infection Presence of bacteria in the blood stream |
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SIRS
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Systemic inflammation in the absence of infection
Pancreatitis, ischemia, immune-mediated organ injury, etc |
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SIRS characterization
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2 or more of the following:
Temperature >38ºC or <36ºC HR > 90 bpm RR > 20 bpm or PaCO2 < 32 mmHg WBC > 12,000/m3 or < 4,000/m3 or > 10% bands |
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True/False.Positive blood culture is the only means to classify shock as Sepsis.
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True.Suspected or proven infection plus 2 or more systemic manifestations of inflammation
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What is Severe Sepsis?
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Sepsis plus one of the following:
Acute organ dysfunction Tissue hypoperfusion Hypotension Note:Positive blood culture not required |
