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3.1.11 - Shock

from Section 3.1 - Cardiac and Circulatory Failure

Published online by Cambridge University Press:  27 July 2023

By
Michael Hoy
Edited by
Ned Gilbert-Kawai ,
Debashish Dutta  and
Carl Waldmann
Ned Gilbert-Kawai
Affiliation:
The Royal Liverpool Hospital
Debashish Dutta
Affiliation:
Princess Alexandra Hospital NHS Trust, Harlow
Carl Waldmann
Affiliation:
Royal Berkshire Hospital, Reading
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Summary

Key Learning Points

  1. 1. Shock may be classified as cardiogenic, hypovolaemic, distributive or obstructive.

  2. 2. The most common cause of shock in the UK is sepsis.

  3. 3. The aetiology of shock is important to distinguish as specific treatments may vary.

  4. 4. Fluid resuscitation underpins a lot of shock management guidelines but appears to be associated with higher vasopressor requirements.

  5. 5. The optimum blood pressure will be patient-specific, but normophysiologic values are not evidence-based.

Keywords

cardiogenic shockseptic shockoxygen deliveryshock trials
Type
Chapter
Information
Intensive Care Medicine
The Essential Guide
 , pp. 132 - 136
Publisher: Cambridge University Press
Print publication year: 2021

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References

References and Further Reading

Gordon, AC, Perkins, GD, Singer, M, et al. Levosimendan for the prevention of acute organ dysfunction in sepsis. N Engl J Med 2016;375:1638–48.CrossRefGoogle ScholarPubMed
IABP-SHOCK II Trial Investigators. Intra-aortic balloon counterpulsation in acute myocardial infarction complicated by cardiogenic shock (IABP-SHOCK II): final 12 month results of a randomised, open-label trial. N Engl J Med 2012;367:1287–96.Google Scholar
Landoni, G, Lomivorotov, VV, Alvaro, G, et al. Levosimendan for hemodynamic support after cardiac surgery. N Engl J Med 2017; 376:2021–31.Google Scholar
Semler, MW. Balanced crystalloids versus saline in critically ill adults. N Engl J Med 2018;378:829–39.Google Scholar

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