, when 2 or more organ systems are affected usually in septic shock that respond to
What is Multiple organ dysfunction
antigens and activate inflammatory response leading to destruction of tissues and
syndrome
organ failure
-CBC
-Lactic acid (tissue damage, muscle damage)
What labs do we want to get for a patient
-ABG
in multi-organ failure
-AST/LST
-BUN/Cr
-Sepsis (most common)
-Severe injury
What are the causes of multi-organ failure -Apoptosis
-Alcohol abuse
-Trauma
-Prevention of sepsis
How can we prevent multi-organ failure?
- early identification of sepsis, antibiotics (broad spectrum) and fluids, antipyretics
Initial Stage
Compensatory Stage
What are the stages of shock?
Progressive Stage
Refractory Stage
Describe the initial stage of shock Marked by hypoxia due to decrease DO2 to the cells
-Compensatory mechanisms to maintain adequate volume, cardiac output. Neural,
endocrine and chemical compensation
Describe the compensatory stage of shock
As BP drops, the body begins compensating by utilizing the RAAS and other systems
to increase BP and return to normal tissue perfusion
-failure of compensatory mechanisms
-Extensive shunting of blood to vital organs
Describe the progressive stage of shock -profound hypo-perfusion
-Worsening metabolic acidosis
-Respiratory acidosis
Describe the refractory stage of shock Prolonged inadequate blood supply to the cells, resulting in cell death and MODS
Hypovolemic shock
cardiogenic shock
List the types of shocks
Distributive Shock
Obstructive Shock
-blood loss due to trauma, GI
What is the cause of hypovolemic shock
-Dehydration from DKA and Burns
sepsis, anaphylaxis, neurogenic problems (CNS disorders, Drugs, Spinal cord injuries)
causes of distributive shock
increased capillary permeability
-MI (severe valvular dysfunction)
-Severe heart failure
Causes of cardiogenic shock
-Cardiomyopathy
-CAD
-Tension pneumothorax
-Cardiac tamponade
Obstructive shock causes
-Severe valvular disease (increase after load)
-PE
Pathology of hypovolemic shock -Rapid fluid loss resulting in inadequate volume