Shock and MODS

  1. What is shock?
    altered tissue perfusion and anaerobic cellular metabolism
  2. How is shock triggered
    Drop in MAP
  3. What causes MAP to change
    cardiac output, total blood volume, and size of vascular bed
  4. What is autorregulation
    ability for tissue to regulate its own blood flow based on needs
  5. What patho changes occur before shock
    MAP ↓10 and ↓blood volume by 500mL
  6. How does the body adjust to small change and what is the outcome
    • SNS activated= ↑HR, CO, peripheral vasoconstriction 
    • perfusion to cells, tissue, and organs
  7. What patho changes occur in Stage 1 of shock (compensatory)
    MAP↓ 10-15mmHg and ↓blood volume 1000mL
  8. What comp mechanisms are activated?
    • SNS=release Epi and Norepi to stimulate α/β → vasoconstriction (nonvital) vasodilation (vital areas) → increase in CO and O2
    • RAAS=VC and aldosterone release → absorb Na/H20 → maintains circ volume 
    • ADH=increase in renal absorption to maintain volume
    • CHP ↓=fluid shifts from interstitial spaces to capillaries
  9. What patho changes occur in Stage 2 of shock (progressive) ?
    MAP↓ 20mmHg+ and ↓blood volume 2500mL

    comp mechanisms are still activated but no longer work
  10. What additional mechanism is activated to help with shock? Consequence?
    • cells switch from aerobic to anaerobic metabolism=lactic acid formation=acidosis 
    • cells swell as Na/water moves in and K out (hyperkalemia) 
    • skin, skeletal muscles, kidneys, and GI no longer perfused 
    • Heart and Brain=anoxic
  11. What patho changes occur in Stage 3 of shock (refractory)?
    • irreversible shock due to widespread tissue anoxia
    • cell death=tissue death=organ death
  12. Can MAP be restored in Stage 3?
    Yes, but cell damage is too severe and organ death causes death of body
  13. What are the sxs of each organ?
  14. What are the 4 classifications of shock?
    Hypovolemic, cardiogenic, obstructive, and distributed
  15. What is hypovolemic shock?
    • 15-25% blood volume loss
    • decrease CO 
    • decrease tissue perfusion
  16. What are the causes of
Card Set
Shock and MODS
Shock and MODS