Hemodynamics/Sepsis: Presentation, Signs/Symptoms Flashcards
Shock definition
potentially fatal physiologic reaction resulting from various conditions including infection, injury, hemorrhage, dehydration, heart failure
Classic definition of shock
Classic definition: hypotension (<90 SBP) or decrease by 40mmHg from baseline
Shock is characterized by what?
Cellular dysoxia: diminished blood circulation, inadequate O2 delivery
Shock outcomes
MOSF, death
End organ dysfunction in shock: CNS
encephalopathy, cortical necrosis
End organ dysfunction in shock: Cardiac
tachy/bradycardia, ventricular ectopy, myocardial ischemia/depression
End organ dysfunction in shock: pulmonary
acute respiratory failure, ARDS
End organ dysfunction in shock: renal
AKI, ATN, prerenal insults
End organ dysfunction in shock: GI
erosive gastritis, ileus, pancreatitis
End organ dysfunction in shock: hepatic
ischemic hepatitis, cholestasis, “shock” liver
End organ dysfunction in shock: hematologic
DIC, dilutioonal thrombocytopenia
End organ dysfunction in shock: metabolic
hyper/hypoglycemia, glycogenolysis, gluconeogenesis, hypertriglyceredemia
End organ dysfunction in shock: immune system
gut barrier function, cellular and humoral immunity depression
Clinical presentation of shock: cardiovascular organ compromise
cardiac index <2.2 L/min/m2, SBP <90 or MAP <65mmHg
Clinical presentation of shock: tissue hypoperfusion
cold, clammy, mottled skin
lactate >2mmol.K
Scvo2 <65%
Svo2 <60%
