Shock Classification Shock Definition: State of cellular and tissue hypoxia due to: reduced oxygen delivery, increased oxygen consumption, inadequate oxygen utilization, or a combination of these processes. Stages: 1. PRE-SHOCK - Compensated shock, cryptic shock. Compensatory responses to diminished tissue perfusion 2. SHOCK - Compensatory mechanisms become overwhelmed, symptomatic tachycardia, dyspnea, cold clammy skin, altered mentation 3. END-ORGAN DYSFUNCTION - Irreversible end-organ damage, multisystem organ failure, and death DISTRIBUTIVE (Warm and Dry): • Most common type (66% of shock) • Septic → dysregulated host response to infection • Neurogenic → in severe traumatic brain or spinal cord injury • Anaphylactic → severe IgE-mediated reaction • Endocrine/Metabolic → addisonian crisis, myxedema, beriberi CARDIOGENIC (Cold and wet) • Cardiomyopathic → myocardial infarction, following cardiac arrest or decompensated heart failure, thyrotoxicosis • Arrhythmic → tachyarrhythmias or bradyarrhythmias • Mechanical → severe aortic or mitral insufficiency, acute valvular rupture, dissection of ascending aorta into valve ring OBSTRUCTIVE (Cold and Dry) • Pulmonary vascular → RV failure from massive pulmonary embolism or severe pulmonary hypertension • Mechanical (impaired venous return/ventricular filling) → tension pneumothorax, cardiac tamponade, constrictive pericarditis, restrictive cardiomyopathy HYPOVOLEMIC (Cold and Dry) • Hemorrhagic → leading to reduced intravascular volume. Most commonly due to trauma or gastrointestinal bleeding • Nonhemorrhagic → volume depletion due to loss of sodium and water #Shock #Classification #Types #diagnosis #management #cold #warm #wet #dry #table
