Foundations- Hypotension & Shock Flashcards
Define Hypotension
Low blood pressure:
SBP<90 OR decrease in SBP of >40 mmHg OR
MAP <60
Define Shock
Physiologic condition of inadequate systemic tissue perfusion
=decreased O2 delivery–> cellular hypoxia and metabolic malfunction
Define Systemic Vascular Resistance (SVR)
Resistance to blood flow offered by ALL of the systemic vasculature
What is SVR influenced by?
- Length
- Diameter
- Blood viscosity
Pre-shock
- Tachycardia
- Peripheral vasoconstriction
- Decreased BP
Clinical presentation of Shock
- Tachycardia
- Dyspnea
- Metabolic acidosis
- Oliguira (decreased urine output)
- Confusion
- Cool, clammy skin
Sx’s of end-organ dysfunction
- Irreversible organ damage
- Coma
- Death
What does the central venous pressure (CVP) measure?
- Pressure in the right atrium
- Correlates to preload or overall volume status
When would you use a Swan-Ganz catheter over a normal central line?
Patients in cariogenic shock
What is the normal pulmonary capillary wedge pressure (PCWP)?
5-15 mmHg
What is normal CP?
4-8 L/min
What is normal systemic vascular resistance (SCR)?
1000-1500 dynes/sec/cm5
Define Hypovolemic Shock
Inadequate intravascular volume–> leads to decrease CO and decrease oxygen delivery
Etiology of Hypovolemic Shock
Hemorrhagic
- Trauma
- GI bleeding
- Internal hemorrhage
- Post-surgical
Non-hemorrhagic
- Dehydration
- Protracted nausea, vomiting, diarrhea
- Burns
- Acute pancreatitis
Define Cardiogenic Shock
Decreased cardiac output secondary to pump failure
