shock 4th year .pdf
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Dr. Fatema Ahmed
MD (Critical Care Medicine)
FCPS ( Med)
Dept. of Critical care Medicine
BIRDEM General Hospital
Organizing secretary( Bangladesh Life support
Shock is an acute clinical syndrome that results from
inadequate tissue perfusion leads to organ dysfunction.
Irrespective of cause, the hypoperfusion-induced imbalance
between the delivery of and requirements for oxygen and
substrate leads to cellular dysfunction.
FINAL COMMON PATHWAY OF SHOCK.
SHOCK VS HYPOTENTION
Shock ≠ Hypotension
Despite significant technologic advances and the improved
understanding of shock, it remains a diagnosis associated
with significant morbidity and mortality.
“Hypoperfusion can be present in the absence of significant hypotension.”
(Don’t only relay on BP for diagnosisng shock)
Hypovolemic shock results from volume loss
Obstructive shock results from impedance of the circulatory channels by an intrinsic or extrinsic obstruction.
Pulmonary embolism, dissecting aneurysm, and pericardial tamponade result in obstructive shock.
Distributive shock is caused by conditions such as direct arteriovenous shunting and is characterized by
decreased resistance or increased venous capacity from the vasomotor dysfunction.
Cardiogenic shock is characterized by primary myocardial dysfunction resulting in the inability of the heart to
maintain an adequate cardiac output with subsequent compromising of metabolic requirements.