Shock Dr Hani Al Sheikh Radhi Shock is

Shock Dr. Hani Al Sheikh Radhi

Shock is a systemic state of low tissue perfusion that is inadequate for normal cellular respiration. With insufficient delivery of oxygen and glucose, cells switch from aerobic to anaerobic metabolism

Pathophysiology Cellular Normal Process the Product is CO 2 & Glucose Levels are maintained Aerobic Metabolism

The Anaerobic Metabolism

Oxygen Deprivation

the Product is Lactic Acid causing systemic acidosis & Glucose Levels decreased anaerobic Metabolism

Lysosome will release digestive enzymes induce cell lysis Low Cellular Glucose due to anaerobic metabolism

Pathophysiology Microvascular Complement and neutrophils Tissue Edema Fluid Leaks between the cells injury of the capillary endothelial cells. Free Radicals & Cytokines

Systemic Effect of Shock CARDIOVASCULAR increased sympathetic activity and release of catecholamines into the circulation. metabolic acidosis and RESPIRATORY increased sympathetic response Decreased perfusion pressure in the kidney leads to reduced RENAL filtration at the glomerulus and a decreased urine output. Vasoconstricti on & Tachycardia increased respiratory rate & increase Co 2 excretion. Produce compensatory resp. alkalosis Stimulate the renin angiotensin which will cause further vasoconstriction and water retention

Ischemia Reperfusion Injury/ Syndrome c e l l u l a r a(IRI) nd Cellular damage + Local Activation of inflammation When Normal circulation is restored further injury occur humoral elements activated by the hypoxia (complement, neutrophils, microvascular thrombi) are flushed back into the circulation where they cause further endothelial