![]() Clinical features and symptoms can vary according to the type and stage of shock. Also, a review of the patient’s outpatient medical records (information regarding risk factors, medications, and trend of baseline vital signs including blood pressure), as well as hospital medical records, could give valuable clues regarding the patient's risk for shock and potential etiology. In the later stages of shock due to progressive volume depletion, cardiac output also decreases and manifest as hypotension. Hypovolemic shock divides into two broad subtypes: hemorrhagic and non-hemorrhagic.Ĭommon causes of hemorrhagic hypovolemic shock includeĪ focused history should be obtained from the patient (if feasible) and/or patient's relatives. ![]() Hypovolemic shock is characterized by decreased intravascular volume and increased systemic venous assistance (compensatory the mechanism to maintain perfusion in the early stages of shock). The underlying mechanism is the disruption of the autonomic pathway resulting in decreased vascular resistance and changes in vagal tone.ĭue to underlying endocrine etiologies such as adrenal failure (Addisonian crisis) and myxedema. Neurogenic shock can occur in the setting of trauma to the spinal cord or the brain. Common allergens include drugs (e.g., antibiotics, NSAIDs), food, insect stings, and latex. ![]() The immediate hypersensitivity reactions can occur within seconds to minutes after the presentation of the inciting antigen. Noninfectious causes of SIRS include but are not limited to pancreatitis, burns, fat embolism, air embolism, and amniotic fluid embolismĪnaphylactic shock is a clinical syndrome of severe hypersensitivity reaction mediated by immunoglobulin E (Ig-E), resulting in cardiovascular collapse and respiratory distress due to bronchospasm. Infectious causes include pathogens such as gram-positive (most common) and gram-negative bacteria, fungi, viral infections (e.g., respiratory viruses), parasitic (e.g., malaria), rickettsial infections. Systemic inflammatory response syndrome (SIRS) is a clinical syndrome of the vigorous inflammatory response caused by either infectious or noninfectious causes. The most common pathogens associated with sepsis and septic shock in the United States are gram-positive bacteria, including streptococcal pneumonia and Enterococcus. Septic shock is a subset of sepsis with severe circulatory, cellular, and metabolic abnormalities resulting in tissue hypoperfusion manifested as hypotension which requires vasopressor therapy and elevated lactate levels (more than 2 mmol/L) Sepsis is defined as life-threatening organ dysfunction resulting from dysregulated host response to infection. ![]() Undifferentiated shock means that the diagnosis of shock has been made however, the underlying etiology has not been uncovered.Ĭharacterized by peripheral vasodilatation. The wide range of etiologies can contribute to each of these categories and are manifested by the final outcome of shock. There are mainly four broad categories of shock: distributive, hypovolemic, cardiogenic, and obstructive. Shock is the final manifestation of a complex list of etiologies and could be fatal without timely management. It is a life-threatening condition of circulatory failure and most commonly manifested as hypotension (systolic blood pressure less than 90 mm Hg or MAP less than 65 mmHg). Shock is characterized by decreased oxygen delivery and/or increased oxygen consumption or inadequate oxygen utilization leading to cellular and tissue hypoxia.
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