Shock

Shock

Shock is a complex metabolic condition characterized by impaired delivery of oxygen and other substrates to tissues. Shock is a syndrome of acute disorder of tissue perfusion, leading to the development of severe energy deficiency and, hence, cell death. Clinically, shock can be characterized as the most acute vascular (cardiovascular in the final) insufficiency as a result of hypovolemia (discrepancy between the capacity of the vascular bed and BCC). The shock is based on a critical decrease in the intensity of blood flow in the microvasculature, causing hypoxia and accumulation of intermediate metabolic products. The reasons

• • Hypoxemia, hypoglycemia, toxins (bacterial and chemical), trauma, bleeding, anaphylactic reaction
  • Violations of the activity of the heart muscle (preload, contractility, afterload).

Pathogenesis

• • Violation of tissue perfusion is a trigger mechanism in the development of shock. Factors determining tissue perfusion: cardiac, vascular, humoral, microcirculatory
  • Activation of compensatory mechanisms to maintain adequate organ perfusion
  • Breakdown of compensation. Hypoperfusion is manifested by impaired functioning of organs and systems
  • Prolonged hypoperfusion leads to cell death (due to exposure to ischemia, inflammatory factors, free radicals)
  • The shock becomes irreversible.

Classification depending on etiopathogenesis. There are hypovolemic (hemorrhagic), septic, cardiogenic, neurogenic, anaphylactic and other types of shock. In practice, this classification is not always applicable, since in many cases shock has a mixed etiology. In particular, in traumatic shock, the effects of blood loss, intoxication and pain are combined. Phases of shock. All forms of shock without treatment go through three phases, the duration of which depends on the cause of the shock.

• • Phase of compensated shock (BP normal)
  • Phase of decompensated shock (BP is reduced)
  • Phase of irreversible shock (damage to organs and systems).

See also Anaphylaxis, Hemorrhagic shock. Cardiogenic shock, Septic shock, Traumatic shock ICD

• • A41.9 Septicemia, unspecified (septic shock)
  • R57.0 Cardiogenic shock
  • R57.1 Hypovolemic shock
  • R57.8 Other types of shock (endotoxic shock)
  • R57.9 Shock, unspecified
  • T78.0 Anaphylactic shock due to abnormal reaction to food
  • T78.2 Anaphylactic shock, unspecified
  • T88.6 Anaphylactic shock due to pathological reaction to adequately applied drugs
  • T88.7 Pathological reaction to drugs or drugs, unspecified
  • T79.4 Traumatic shock