Basics of Endotoxemia and Shock Flashcards
What body water fraction is hypovolemia
plasma (25% of ECF)
what body water fraction is dehydration
Interstitial fluid (75% of ECF
components of hypovolemic shock
decreased venous return, cardiac output, and tissue perfusion. this leads to tissue hypoxia and irreversible cell damage
classifications of shock
hypovolemic cardiogenic obstructive distributive (sepsis) cytotoxic
basics of fluid therapy for shock
restore volume, distribution and content
effects of lactic acidosis
myocardial depression
less responsiveness to catecholamines
cns effects
Who to not give the hypertonic saline to
severely dehydrated patients (only hypovolemics)
clinical signs of hypovolemia and hypotension
loss of BP poor pulse collapsed veins poor venous fill poor capillary fill this will cause compensation by cold shock
the best way to improve tissue oxygenation is
restore circulating volume
indications for blood transfusions
> 20-30% of blood is lost
What will fluids added do to PCV
witll drop it
C/S of early de-comp stages of shock
pallor/cyanosis, prolonged CRT, low BP
autoregulatory escape as a decomp mechanism in shock
complete circulatory collapse, bradycard no CRT no pulse stupor, coma
pathophysiology of septic shock
microvascular pooling- –> blood pooling –> shunting of blood –> endothelial damage –> thrombosis –> increased permeability –> edema
this is an apparent hypovolemia but the vessels and dilated and nonresponsive
Tx principles for septic shock
fluids
address cause - drain, devitalize tissue debridement, AM
anti-inflammatores - NSAIDs steroids, flunixin
anti-endotoxin therapy - polymixin B, plasma
prevent complications
