CIRCULATORY SHOCK

CIRCULATORY SHOCKSyndrome in which there is inadequate tissue

perfusion associated with relative or absolute decrease in cardiac output.

TYPESHypovolemic shockDistributive shockCardiogenic shockObstructive shock

HYPOVOLEMIC SHOCKCommonest of all shocks.Common forms: Hemorrhagic, traumatic,

surgical and burn shocks.

HEMORRHAGIC SHOCKCommonest of all shocks.Cause : Acute hemorrhage of more than 15ml/kg

body weight.Features:

Hypotension Tachycardia, Tachypnoea Restlessness Rapid and thready pulse Cold and pale skin Intense thirst Usually conscious

STAGES OF SHOCK

REVERSIBLE STAGERapid compensatory mechanismsLong-term compensatory mechanisms

RAPID COMPENSATORY MECHANISMS1. Tachycardia2. Vasoconstriction3. Increased venous return4. Increased thoracic pumping5. Increased skeletal muscle pumping6. Capillary fluid shift7. Activation of chemoreceptor reflex8. Activation of Cushing’s reflex9. Increased secretion of Catecholamines10. Increased secretion of vasopressin11. Increased secretion of Cortisol12. Activation of Rennin-Angiotensin system13. Increased secretion of Aldosterone

LONG-TERM COMPENSATORY MECHANISMS

1. Increased synthesis of Erythropoietin2. Increased plasma protein synthesis

IRREVERSIBLE SHOCKCompensatory mechanisms fail to improve

body functions.Refractory shock or irreversible shock.

FEATURESPre-capillary sphincters constrictPre-capillary sphincters dilateEntry of bacteria into circulationCardio-respiratory centres depressedMyocardial function decreasesDisseminated intravascular coagulationPulmonary microembolism

OTHER TYPESDistributive shock

a) Anaphylactic shockb) Septic shockc) Endotoxic shockd) Neurogenic shock

Cardiogenic shockObstructive shock

TREATMENT OF SHOCKBlood transfusionPlasma transfusionEpinephrineDopamineNo sedativesPrevent over-warming of body

THANK YOU

-R.MARIA JECINTHA RINA