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shock休克英文;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(effective circulating blood volume)↓ →microcirculation disturbances
sympathetic activation;systemic inflammatory response syndrome, SIRS全身炎症反应综合征
pro-inflammatory anti-inflammatory 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 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
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