Shock - Differential Diagnosis Framework MAP = CO x SVR Hypovolemic (↓ Intravascular volume): • Hemorrhage, dehydration due to renal/Gl losses, poor PO intake, severe burns, third-spacing • ↓ CO, ↑ SVR, ↓ PCWP • Exam: ↓ JVP, extremities, narrow pulse pressure, pallor Cardiogenic (Intra-cardiac pump failure): • Severe heart failure, acute MI, arrhythmia • ↓ CO, ↑ SVR, ↑ PCWP • Exam: ↑ JVP, extremities. narrow pulse pressure, S3, crackles Obstructive (Extra-cardiac pump failure): • Mechanical → tension PTX, cardiac tamponade, Vascular → PE, PAH • ↓ CO, ↑ SVR, ↓ PCWP • Exam: ↑ JVP, extremities. narrow pulse pressure, other findings based on cause Distributive (↓ Vascular tone): • Sepsis. neurogenic, anaphylaxis, release syndrome, infusion reactions, adrenal crisis, drugs/toxins • ↑ CO, ↓ SVR, ↓ PCWP • Exam: ↓ JVP, warm extremities, wide pulse pressure by Lauren Banaszak, MD @LaurenBzak via @uw_IMresidency #Shock #Differential #Diagnosis #table #comparison #criticalcare
