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SHOCK
Inadequate organ perfusion (blood flow rate) to
meet the tissues oxygenation demand
tissue hypoperfusion
Factors determining tissue perfusion
A. cardial: cardiac output
B. vascular: changes in vascular resistance
C. humoral: renin, vazopresin, prostaglandins, kinins,
atrial natriuretic factor
Classification and Etiology of
Acute circulatory shock
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ASSOCIATED CAUSES AND DISORDERS
- Dissecting aneurysm of aorta
- Pericardial tamponade
- Aortic valve disease
- Myocardial infarction
- Progressive myocarditis
- Drugs and alcohol
- Diuresis
- Pulmonary congestion
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IF PROMPT TREATMENT IS NOT GIVEN,
SYSTEMIC CONSEQUENCES OCCUR
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Stages of shock
1. Non-progressive stage (compensated)
Compensatory mechanisms (negative feedback) of the
circulation can return CO and BP to normal levels
Special features:
1. high fever
2. marked vasodilatation (inflammation)
3. or normal CO: vasodilatation, metabolic rate
4. disseminated intravascular coagulation clotting factors to
be used up hemorrhages occur into many tissue in GIT
Multiorgan failure
Kidney
- blood flow (to 10%) GF oliguria
- ischemia acute tubular necrosis
- countercurrent mechanism failure and lesions
acute renal failure
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TREATMENT
- Restore and maintain cardiac output
- Identify the cause and special treatment for it
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Acute Pulmonary oedema / Left side cardiac
problem
Diuretics
Vasodilators
Morphine (Relieve breathlessness and reverse vaso
constriction, reduce pain)
High concentration of oxygen supply
Ionotropic agents (Stimulate heart functioning)
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