Types of Shock Reactions

Question 1

Hypovolemic
HR:
CI:
MAP:
CVP:
PCWP:
SVR:

Answer 1

cause- hemorrhage/severe dehydration= reduced BV
effect:
HR: ^ increase
CI: r (reduced SV/V to pump)
MAP: r (reduced V in vasc)
CVP: r (reduced V in vasc)
PCWP: r (reduced V in vasc)
SVR: ^increase- compensate (low P--> ^SNS*)

Question 2

Distributive (Septic/Anaphylactic/Neurogenic) 
HR:
CI:
MAP:
CVP:
PCWP:
SVR:
Distinguishing Feature?

Answer 2

cause- cytokine storm + ^ vasc permeability + dilation
denervation w brain/brainstem/spine injury
–>profound dilation
effect:
HR: ^increase
CI:^ increase (compensatory ^ hr= ^ CO)
MAP: r (reduced V in vasc)
CVP: r (reduced V in vasc)
PCWP: r (reduced V in vasc)
**SVR: REDUCED (cause of shock)

Dgx_ reduced SVR + “warm” temp

Question 3

Cardiogenic
HR:
CI:
MAP:
CVP:
PCWP:
SVR:

Answer 3

cause- ineffective pump= reduced CO
effect:
 HR: ^increase
CI: r (reduced ability to pump)
MAP: EITHER 
CVP: (^ RHF) /(N w LHF)
PCWP: (^ LHF)/ (N w RHF) 
SVR:^ increase (compensate for low P--> SNS*)

Dgx) CVP + PCWP determine side of heart

Question 4

Neurogenic
HR:
CI:
MAP:
CVP:
PCWP:
SVR:

Answer 4

cause- denervation of SNS + PNS input= vasoDILATION
effect: 
HR: ^increase
CI: ^increase (compensatory ^ HR= ^ CO)
MAP: reduced (profound vasodilation)
CVP: reduced (profound vasodilation)
PCWP: reduced 
SVR: reduced (denervation= vasodilation)