Causes, classification and compensatory responses to shock.


Shock can be caused by any pathological process that leads to intravascular volume loss, pathological vasodilatation, myocardial dysfunction or obstruction of either venous return (as occurs in severe asthma) or ventricular outflow. Shock can be categorized as distributive (septic), hypovolaemic, cardiogenic or obstructive. Shock can also present a mixed picture; for example, in sepsis, burns and anaphylaxis, increased vascular permeability leads to loss of intravascular volume and hypovolaemic shock, while at the same time, pathological vasodilatation produces distributive shock. The compensatory responses to all forms of shock are similar. The cause of shock might be obvious (as in patients with trauma or massive haemorrhage) or unclear (unresuscitated septic shock is often clinically indistinguishable from hypovolaemic shock). RAAS, renin–angiotensin–aldosterone system.


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