Shock Classification
Shock Definition: State of cellular ...
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Shock Classification

Shock Definition: State of cellular and tissue hypoxia due to: reduced oxygen delivery, increased oxygen consumption, inadequate oxygen utilization, or a combination of these processes.

Stages:

1. PRE-SHOCK - Compensated shock, cryptic shock. Compensatory responses to diminished tissue perfusion

2. SHOCK - Compensatory mechanisms become overwhelmed, symptomatic tachycardia, dyspnea, cold clammy skin, altered mentation

3. END-ORGAN DYSFUNCTION - Irreversible end-organ damage, multisystem organ failure, and death

DISTRIBUTIVE (Warm and Dry):

 • Most common type (66% of shock)

 • Septic → dysregulated host response to infection

 • Neurogenic → in severe traumatic brain or spinal cord injury

 • Anaphylactic → severe IgE-mediated reaction

 • Endocrine/Metabolic → addisonian crisis, myxedema, beriberi

CARDIOGENIC (Cold and wet)

 • Cardiomyopathic → myocardial infarction, following cardiac arrest or decompensated heart failure, thyrotoxicosis

 • Arrhythmic → tachyarrhythmias or bradyarrhythmias

 • Mechanical → severe aortic or mitral insufficiency, acute valvular rupture, dissection of ascending aorta into valve ring

OBSTRUCTIVE (Cold and Dry)

 • Pulmonary vascular → RV failure from massive pulmonary embolism or severe pulmonary hypertension

 • Mechanical (impaired venous return/ventricular filling) → tension pneumothorax, cardiac tamponade, constrictive pericarditis, restrictive cardiomyopathy

HYPOVOLEMIC (Cold and Dry)

 • Hemorrhagic → leading to reduced intravascular volume. Most commonly due to trauma or gastrointestinal bleeding

 • Nonhemorrhagic → volume depletion due to loss of sodium and water



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Contributed by

Dr. Gerald Diaz
@GeraldMD
Board Certified Internal Medicine Hospitalist, GrepMed Editor in Chief 🇵🇭 🇺🇸 - Sign up for an account to like, bookmark and upload images to contribute to our community platform. Follow us on IG:  https://www.instagram.com/grepmed/ | Twitter: https://twitter.com/grepmeded/
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