shock 老外讲的,10年后的,有休克的简明分类与循环构架.pptVIP

下载本文档

2
0
约1.15万字
约 75页
2017-12-08 发布于河南
举报
版权申诉

shock 老外讲的,10年后的,有休克的简明分类与循环构架.ppt

1、原创力文档（book118）网站文档一经付费（服务费），不意味着购买了该文档的版权，仅供个人/单位学习、研究之用，不得用于商业用途，未经授权，严禁复制、发行、汇编、翻译或者网络传播等，侵权必究。。
2、本站所有内容均由合作方或网友上传，本站不对文档的完整性、权威性及其观点立场正确性做任何保证或承诺！文档内容仅供研究参考，付费前请自行鉴别。如您付费，意味着您自己接受本站规则且自行承担风险，本站不退款、不进行额外附加服务；查看《如何避免下载的几个坑》。如果您已付费下载过本站文档，您可以点击这里二次下载。
3、如文档侵犯商业秘密、侵犯著作权、侵犯人身权等，请点击“版权申诉”（推荐），也可以打举报电话：400-050-0827(电话支持时间：9:00-18:30)。
4、该文档为VIP文档，如果想要下载，成为VIP会员后，下载免费。
5、成为VIP后，下载本文档将扣除1次下载权益。下载后，不支持退款、换文档。如有疑问请联系我们。
6、成为VIP后，您将拥有八大权益，权益包括：VIP文档下载权益、阅读免打扰、文档格式转换、高级专利检索、专属身份标志、高级客服、多端互通、版权登记。
7、VIP文档为合作方或网友上传，每下载1次，网站将根据用户上传文档的质量评分、类型等，对文档贡献者给予高额补贴、流量扶持。如果你也想贡献VIP文档。上传文档

shock 老外讲的,10年后的,有休克的简明分类与循环构架

SHOCK Philip Jones, PGDip, MD, FRCPC Department of Anaesthesia and Cardiac Critical Care Definition of Shock “A clinical state in which tissue blood flow is inadequate for tissue requirements or oxygen utilization is impaired. There is either insufficient oxygen delivery, maldistribution of oxygen delivery to vital tissues or impaired utilization” Simply... At cellular level... shock is a state of acute nutritional insufficiency for oxygen and other essential substrates, resulting in cellular anoxia, cellular dysfunction and eventually, cell death Types of Shock distributive shock (abnormal vascular tone) hypovolaemic shock (decreased blood volume) obstructive shock (obstructed blood volume) cardiogenic shock (abnormal pump function) Determinants of Blood Pressure Determinants of Blood PressureDistributive shock Determinants of Blood PressureHypovolaemic shock Determinants of Blood PressureObstructive shock Determinants of Blood PressureCardiogenic shock Types of Shock distributive shock (abnormal vascular tone) hypovolaemic shock (decreased blood volume) obstructive shock (obstructed blood volume) cardiogenic shock (abnormal pump function) Determinants of Blood PressureDistributive shock Distributive (hyperdynamic) Shock Hyperdynamic state with high cardiac output Normal to low filling pressures Decreased systemic vascular resistance Mixed venous oxygen may be normal or increased Distributive (hyperdynamic) Shock causes: SIRS (sepsis, burns, trauma, pancreatitis) neurogenic (spinal trauma) anaphylaxis / anaphylactoid endocrine (thyroid, myxoedema, adrenal) pharmacologic (vasodilators, benzodiazepines) Septic Shock not JUST vasodilation! impaired systolic function (decreased stroke volume, contractility) caused by myocardial depressant factors impaired diastolic function with altered LV compliance (PCWP and LVEDV) decreased systemic vascular resistance (inducible nitric oxide synthetase) Types of Shock distributive shock (abnormal vascular tone) hypovolaemic s