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Chapter 11 Shock;What’s shock？; hypotension？;vasoconstrictive treatment →vasodilative treatment; Lartin General Critical Reaction: strike and vibration 1731, Henri Francois Le Dran apply to medicine for the first time;pale face cyanosis cold and clammy limbs oliguria faint consciousness hypotension;“sympathetic failure theory”;blood volume↓ ECBV↓ →microcirculation disturbances sympathetic activation;systemic inflammatory response syndrome, SIRS全身炎症反应综合征 pro-inflammatory anti-inflammatory humeral factors; Regardless of causes, shock is defined as a clinical condition and pathophysiologic process characterized by microcirculation dysfunction inadequate blood flow vital organs and inability of cell body mass to metabolize normally. causes → acute circulatory failure → microcirculation disturbance → ECBV(effective circulatory blood volume) ↓→ “low flow state” in vital organs → abnormal cellular metabolism and function, tissue injury, dysfunction of vital organs → shock ;1.Loss of blood or fluid: Blood loss: peptic ulcer, varices due to portal hypertension Fluid loss: severe vomiting, diarrhea, intestinal obstruction (collapse) 2.Burn: early stage: loss of body fluid, pain later stage: loss of body fluid, infection 3.Trauma: hemorrhage, severe pain 4.Infection: G- infection → release of endotoxins sepsis;5.Anaphylaxis:; 6.Strong stimulation on nerve system: brain injury, the depressant action of drugs, general anesthesia, hypoxia, or lack of glucose, spinal anesthesia or spinal cord injury → decreased sympathetic control;According to Etiology: ; blood volume c