Shock and Multiple Organ Dysfunction Syndrome

Flashcards for reviewing shock, its classifications, stages, and related concepts like SIRS and MODS.

Shock

Inadequate perfusion at the tissue level resulting in a decreased supply of O2 and nutrients required to maintain the metabolic needs of the body; "The reversible stage of dying."

Hypovolemic Shock

Shock due to decreased intravascular volume.

Cardiogenic Shock

Shock due to the heart's inability to generate sufficient cardiac output.

Obstructive Shock

Shock due to a physical obstruction to blood flow (e.g., tension pneumothorax, pericardial tamponade, pulmonary embolism).

Distributive Shock

Shock characterized by widespread vasodilation and decreased systemic vascular resistance (e.g., neurogenic, anaphylactic, septic shock).

Systemic Inflammatory Response Syndrome (SIRS)

A widespread systemic inflammatory response that upsets the balance between pro-inflammatory and anti-inflammatory processes; normally a localized process that becomes systemic.

Peripheral Venous Lactate Level

A marker for cellular hypoxia; normal lactate is less than 2.0 mmol/L; a level above 4.0 mmol/L is associated with an increased mortality rate.

Initiation Stage of Shock

The first stage of shock characterized by hypoperfusion and no obvious clinical signs; early and reversible.

Compensatory Stage of Shock

The second stage of shock characterized by a sustained reduction in tissue perfusion and the initiation of compensatory mechanisms (neural, endocrine, chemical).

Progressive Stage of Shock

The third stage of shock characterized by the failure of compensatory mechanisms and profound cardiovascular effects.

Refractory Stage of Shock

The fourth and final stage of shock characterized by prolonged inadequate tissue perfusion that is unresponsive to therapy, contributing to multiple organ dysfunction and death.

Septic Shock

A type of distributive shock caused by a bacterial endotoxin entering the body, leading to a spiral out of control of normally protective inflammatory processes, vessel dilation and increased permeability, Occlusion of microvasculature, Generalized ischemia, Dilated intravascular compartment, “Leaky” vascular compartment, Hypotension, Tachypnea, respiratory alkalosis, Tachycardia.

Anaphylactic Shock

A type of distributive shock; Circulatory failure related to biochemical abnormalities secondary to a systemic allergic reaction qExposure to allergen leads to the production of IgE antibodies qRelease of biochemical mediators qLeaky vascular compartment qVasodilation qMassive 3rd space fluid shifting

Neurogenic Shock

A type of distributive shock initiated by damage to and/or dysfunction of the sympathetic nervous system, produced by spinal cord damage or pharmacological blockade of the sympathetic nervous system at the level of T-6 or higher, interruption of vasoconstrictor or cardioaccelerator impulses

Cardiogenic Shock

A type of shock when Heart is unable to generate sufficient CO; 80-100% mortality; May occur in association with normal or elevated CO; Tachydysrhythmias; Bradydysrhythmias; Myocardial depression due to electrolyte imbalances, hypoxemia, drugs, etc., Mechanical defects, Major surgery or trauma, or AMI.

Multiple Organ Dysfunction Syndrome (MODS)

Progressive dysfunction of two or more organ systems; most common causes are Sepsis or Septic shock; Can occur after any severe injury or illness.