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20 Cards in this Set
- Front
- Back
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What are the consequences of shock
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death or multiple organ dysfunction
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Clinical presentation of shock
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SBP <90 or MAP <65
Tachy >90 Tachypnea RR >20 altered mental status decreased organ perfusion decreased urine output metabolic acidosis |
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Hemodynamics of Hypovolemic shock
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decrease PCWP
decrease CO increase SVR |
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Hemodynamics of cardiogenic shock
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decease CO
increase PCWP increase SVR |
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Hemodynamics of septic shock
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decrease SVR
increase CO decrease PCWP |
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What is hypovolemic shock and etiologies
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Hemorrhagic
-trauma/surgery -internal bleeding --aortic aneurysm --gi bleed --retroperitoneal bleed Non-hemorrhagic -dehydration -ascities -fluid loss burns,heat stroke |
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Goals of hypovolemic shock
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PCWP 10-12
CVP 15 CI 3 L/min |
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What is cardiogenic shock
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sustained hypotension and reduced CI leads to inadequate tissure perfusion due to cardiac dysfuction
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Causes of cardiogenic shock
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acute Mitral regurg
rupture of interventricular septum acute MI myocarditis end-stage cardiomyopathy myocardial contusion septic shock with sever myocardial depression valvular heart dz hypertrophic obstructive cardiomyopathy |
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Goals of management of cardiogenic shock
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CI >2.5
PCWP <18 MAP >65 Uout >0.5 ml/kg/hr |
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Rationale of inotropes in cardiogenic shock
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increase contracility increase HR and CO
peripheral vasodilation |
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rationale of vasopressors in cardiogenic shock
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increase MAP
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rationale of diuretics in cardiogenic shock
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decrease PCWP
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rationale of vasodilators in cardiogenic shock
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decrease SVR but last line
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Mechanical options for cardiogenic shock
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intra-aortic balloon pump
ventricular assist device bi-vent assist device |
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primary etiology of responsible of vasodilatory shock also called septic
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infections
anaphylaxis neurogenic drug-induced acute adrenal insuffciency |
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what is sepsis
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SIRS with presence of infection
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what is severe sepsis
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sepsis with organ dysfunction defined my MODS of SOFA
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What is septic shock
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sepsis with hypotension despite adequate volume resus. SBP <90 of MAP <60
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What qualilfies as systemic inflammatory response syndrome (SIRS)
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core temp >38.3 <36
HR >90 RR >20 or PaO2 <32 WBC >12,000 or <4000 or >10% bands |
