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1 - Shock

from Section 1 - General Critical Care

Published online by Cambridge University Press:  02 November 2023

By
Kenneth R. L. Bernard
Edited by
Kaushal Shah  and
Jarone Lee
Edited in association with
Clark G. Owyang  and
Benjamin Christian Renne
Kaushal Shah
Affiliation:
Weill Cornell Medical Center, New York
Jarone Lee
Affiliation:
Massachusetts General Hospital, Boston
Clark G. Owyang
Affiliation:
Weill Cornell Medical Center, New York
Benjamin Christian Renne
Affiliation:
Massachusetts General Hospital, Boston
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Summary

Shock is a pathological state resulting from inadequate delivery, increased demand or poor utilization of metabolic substrates (i.e., oxygen and glucose), which leads to cellular dysfunction and cell death. This then leads to progressive acidosis, endothelial dysfunction and inflammatory cascade that results in end-organ injury. Early in the course of shock, compensatory mechanisms may attempt to augment cardiac output (CO) and/or systemic vascular resistance (SVR) in an effort to improve tissue perfusion. Without treatment, those compensatory mechanisms are overwhelmed, leading to decompensated shock, multiorgan failure (MOF) and death.

Keywords

shockhypotensioncardiac outputsystemic vascular resistancehypovolemicdistributivecardiogenicsepsisobstructive
Type
Chapter
Information
Practical Emergency Resuscitation and Critical Care , pp. 3 - 14
Publisher: Cambridge University Press
Print publication year: 2023

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References

Vincent, J-L, & De Backer, D. Circulatory shock. New Engl J Med 2013;369(18):1726–1734.CrossRefGoogle ScholarPubMed
De Backer, D, Biston, P, Devriendt, J, et al. Comparison of dopamine and norepinephrine in the treatment of shock. New Engl J Med 2010;362(9):779–789.CrossRefGoogle ScholarPubMed
Gamper, G, Havel, C, Arrich, J, et al. Vasopressors for hypotensive shock. Cochrane Database Syst Rev 2016;2.Google ScholarPubMed
Rhodes, A, Evans, L, Alhazzani, W, et al. Surviving sepsis campaign: International guidelines for management of sepsis and septic shock: 2016. Intensive Care Med 2017;43(3):304–377.CrossRefGoogle ScholarPubMed

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  • Shock
  • Edited by Kaushal Shah, Weill Cornell Medical Center, New York, Jarone Lee, Massachusetts General Hospital, Boston
  • Edited in association with Clark G. Owyang, Weill Cornell Medical Center, New York, Benjamin Christian Renne, Massachusetts General Hospital, Boston
  • Book: Practical Emergency Resuscitation and Critical Care
  • Online publication: 02 November 2023
  • Chapter DOI: https://doi.org/10.1017/9781009052566.003
Available formats
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  • Shock
  • Edited by Kaushal Shah, Weill Cornell Medical Center, New York, Jarone Lee, Massachusetts General Hospital, Boston
  • Edited in association with Clark G. Owyang, Weill Cornell Medical Center, New York, Benjamin Christian Renne, Massachusetts General Hospital, Boston
  • Book: Practical Emergency Resuscitation and Critical Care
  • Online publication: 02 November 2023
  • Chapter DOI: https://doi.org/10.1017/9781009052566.003
Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

  • Shock
  • Edited by Kaushal Shah, Weill Cornell Medical Center, New York, Jarone Lee, Massachusetts General Hospital, Boston
  • Edited in association with Clark G. Owyang, Weill Cornell Medical Center, New York, Benjamin Christian Renne, Massachusetts General Hospital, Boston
  • Book: Practical Emergency Resuscitation and Critical Care
  • Online publication: 02 November 2023
  • Chapter DOI: https://doi.org/10.1017/9781009052566.003
Available formats
×