Shock Flashcards
What is systemic inflammatory response syndrome?
Exaggerated and systemic manifestation of a local inflammatory reaction, often fatal
What are the major mediators of SIRS?
TNF
IL-1
IL-6
PAF
What is the diagnosis for SIRS?
Two or more signs of systemic inflammation
*Fever, Tachycardia, tachypnea, leukocytosis or leukopenia
What is sepsis?
SIRS with a culture-proven infection or obvious infection
What is septic shock?
Clinical SIRS severe enough to lead to hypotension and organ dysfunction
What is the number one cause of death in ICUs?
Septic Shock
What are the three major consequences of endothelial cell activation?
Thrombosis
Increased vascular permeability
Vasodilation
What are the metabolic abnormalities and their mediators associated with septic shock?
Gluconeogenesis - cytokines, hormones and catecholamines
Insulin resistance/insulin suppression - cytokines
What organs are particularly affected in septic shock?
Kidneys, Liver, Lungs, Heart
What are the stages of shock?
Nonprogressive phase
Progressive stage
Irreversible stage
What occurs in the nonprogressive stage of shock?
Reflex mechanisms compensate and tissue perfusion is maintained (SIRS)
What occurs in the progressive stage of shock?
Tissue hypoperfusion ensues with worsening circulatory and metabolic imbalances including acidosis
What occurs in the irreversible stage of shock?
Extensive cellular and tissue injury has occurred that even with infection control and hemodynamic correction, death is inevitable
