RT Book, Section
A1 Young, William F.
A2 Stone, C. Keith
A2 Humphries, Roger L.
SR Print(0)
ID 55747657
T1 Chapter 11. Shock
T2 CURRENT Diagnosis & Treatment Emergency Medicine, 7e
YR 2011
FD 2011
PB The McGraw-Hill Companies
PP New York, NY
SN 978-0-0-07-170107-5
LK accessmedicine.mhmedical.com/content.aspx?aid=55747657
RD 2024/04/24
AB Shock  is  a  state  of  severe  systemic  reduction  in  tissue  perfusion  characterized  by  decreased  cellular  oxygen  delivery  and  utilization  as  well  as  decreased  removal  of  waste  byproducts  of  metabolism.  Hypotension,  although  common  in  shock,  is  not  synonymous  to  shock.  One  can  have  hypotension  and  normal  perfusion,  or  shock  without  hypotension  in  a  patient  who  is  usually  very  hypertensive.  Shock  is  the  final  preterminal  event  in  many  diseases.  Progressive  tissue  hypoxia  results  in  loss  of  cellular  membrane  integrity,  a  reversion  to  a  catabolic  state  of  anaerobic  metabolism,  and  a  loss  of  energy-dependent  ion  pumps  and  chemical  and  electrical  gradients.  Mitochondrial  energy  production  begins  to  fail.  Multiple  organ  dysfunction  follows  localized  cellular  death,  and  organism  death  follows.  Despite  recent  advances  in  treatment,  mortality  remains  high:  >  50%  in  cardiogenic  shock  and  >  35%  in  septic  shock.