Distributive Shock

Question 1

Discuss causes of distributive shock. Discuss management strategies for various forms of distributive shock.

Answer 1

Distributive shock is a type of shock that is caused by systemic vasodilation, leading to decreased systemic vascular resistance (SVR) and increased cardiac output.

Vasodilation leads to hypotension, decreased tissue perfusion, and altered mental status.

Causes of Distributive Shock:

1. Septic shock: Septic shock is caused by a bacterial or viral infection and can lead to distributive shock due to vasodilation and systemic inflammation.
2. Anaphylaxis: Anaphylaxis is an acute, severe, and potentially life-threatening allergic reaction that can cause vasodilation and lead to distributive shock.
3. Neurogenic shock: Neurogenic shock is caused by damage to the autonomic nervous system, leading to profound vasodilation and decreased SVR.
4. Endocrine disorders: Endocrine disorders such as hypothyroidism and adrenal insufficiency can lead to a decrease in SVR and distributive shock.

Management Strategies for Distributive Shock:

1. Fluid resuscitation: is the cornerstone of management for distributive shock and involves the administration of intravenous fluids, such as crystalloids and colloids, to restore intravascular volume and increase SVR.
2. Vasopressors: can be used to increase SVR and restore blood pressure in patients with distributive shock.
3. Inotropes - used to increase cardiac output in patients with distributive shock.
4. Antibiotics: treat bacterial infections that can lead to distributive shock, such as septic shock.
5. Corticosteroids: treat systemic inflammation that can lead to distributive shock, such as anaphylaxis.
6. Oxygen therapy: treat hypoxemia in patients with distributive shock.
7. Other medications: Other medications, such as beta-blockers, may be used to treat the underlying cause of distributive shock.