vetsci shock/fluid therapy

shock

• inadequate tissue perfusion

  • poor oxygen delivery

  • inadequate cellular energy production

compensatory shock signs

• vascular constriction

  • increased HR

  • bounding pulse

  • increased CRT

  • BP high/normal

  • temp normal

early decompensatory shock

• dull or obtunded

• tachycardia

• weak/thready pulse

• pale mm

• increased CRT

• BP low/normal

• temp lower

late decompensatory shock

• obtunded or unconscious

• bradycardia

• thready/absent pulse

• grey/purple mm

• increased/unmeasurable CRT

• BP low

• temp cold

hypovolemic shock

decreased circulating blood volume

hypovolemic shock- causes

• hemorrhage

• V/D

• renal insufficiency

• severe dehydration

• addisons

hypoxic shock

• decreased arterial oxygen

hypoxic shock- causes

• anemia

  • IMHA, hemorrhage, tick born disease, coagulopathy

• resp. dz

  • CHF, asthma, pneumonia, pulmonary hypertension

cardiogenic shock

• results from heart failure

• heart cannot function in a way that allows for proper CO

cardiogenic shock- causes

• congenital heart dz

  • valvular stenosis, PDA

• aqquired dz

  • HCM/DCM, valvular insufficiency, arrythmias

disstributive shock

• inappropriate vasodilation

• normal blood vol is inadequate to fill vascular compartment

distributive shock- types

• sepsis/SIRS

• anaphylactic

• neurogenic

septic shock- cause

• systemic infection or inflammation

• driven by inflammatory mediators

anaphylactic shock- causes

• assault on immune system

• histamine release

neurogenic shock- causes

• decrease in vasomotor tone

• mass

• toxin/drug

• hypoglycemia

obstructive shock

• obstruction in circulatory system

• anything that mechanically prevents blood delivery to/from the heart

obstructive shock- causes

• GDV

• thromboembolism

• heeartworm

• pericardial effusion/tamponade

• pneumothorax

metabolic shock

• inadequate nutrients for ATP production, or poor utilization

metabolic shock- causes

• hypoglycemia

• increased loss

  • V/D, renal insufficiency

• toxins

• severe alkalosis/acidosis

sensible fluid losses

• urine

• blood

• feces

insensible fluid losses

• perspiration

• respiration