What are the three types of distributive shock?
Types
- Class I: all capillaries are stagnant when there is normal or sluggish venular flow.
- Class II: there are empty capillaries next to capillaries that have flowing red blood cells.
- Class III: there are stagnant capillaries next to capillaries with normal blood flow.
- Class IV: hyperdynamic flow in capillaries adjacent to capillaries that are stagnant.
What are the causes and signs of distributive shock?
There are four types of shock:
- Hypovolemic shock: Shock due to blood loss
- Distributive shock: Shock due to an imbalanced internal fluid volume
- Cardiogenic shock: Shock due to the heart not working properly
- Obstructive shock: Shock due to a blockage of a major blood vessel or the heart
What are the symptoms of distributive shock?
- Low blood pressure is an early sign (unlike other forms of shock)
- Normal heart rate (can be elevated, but is the type of shock most likely to have a normal rate)
- A "line" on the body where skin is pale above and flushed red below
What are characteristics of distributive shock?
- Core temperature of higher than 38°C (100.0°F) or lower than 36°C (96.8°F)
- Heart rate of more than 90 beats per minute
- Respiratory rate of more than 20 breaths per minute or arterial carbon dioxide tension (PaCO 2) less than 32 mm Hg
- White blood cell (WBC) count of more than 12,000/µL, less than 4,000/µL, or more than 10% immature (band) forms
What is distributive shock examples?
The three types of distributive shock are: Example: An allergic reaction to peanuts that leads to anaphylactic shock. Neurogenic shock (from a spinal cord injury that has damaged your nervous system). Example: A diving accident that injures your spinal cord and leads to neurogenic shock.
What is distributive shock signs and symptoms?
Distributive shock is difficult to recognize because the signs and symptoms vary greatly depending on the etiology. Common symptoms include tachypnea, tachycardia, low to normal blood pressure, decreased urine output, and decreased level of consciousness.
What is distributive shock quizlet?
What is distributive shock? excess vasodilation and altered distribution of blood flow w. shunting of blood flow from vital organs to non vital tissues.
What causes distributive shock?
Distributive shock as a result of sepsis occurs due to a dysregulated immune response to infection that leads to systemic cytokine release and resultant vasodilation and fluid leak from capillaries.
What is the most common form of distributive shock?
Distributive shock results from excessive vasodilation and the impaired distribution of blood flow. Septic shock is the most common form of distributive shock and is characterized by considerable mortality (treated, around 30%; untreated, probably >80%).
What are the three types of distributive shock?
Distributive shock The three subtypes are septic, anaphylactic/anaphylactoid, and neurogenic shock.
What can hypovolemic shock cause?
Hypovolemic shock is a serious medical problem that requires immediate treatment. A large loss of blood or fluids prevents your organs from getting the oxygen and nutrients they need to function. This can lead to organ failure and can be fatal.
How does hypovolemic shock occur?
Losing about one fifth or more of the normal amount of blood in your body causes hypovolemic shock. Blood loss can be due to: Bleeding from cuts. Bleeding from other injuries.
What is distributive shock?
Distributive shock, also known as vasodilatory shock, refers to systemic vasodilation and decreased blood flow to vital organs such as the brain, h...
What are the three main types of distributive shock?
The three main types of distributive shock are septic shock, anaphylactic shock, and neurogenic shock.Septic shock refers to the condition where an...
What is the most common form of distributive shock?
Of the three major forms of distributive shock, septic shock is the most common cause seen in the emergency room. Approximately one million people...
What causes distributive shock?
Distributive shock has several causes depending on the specific subtype. In the case of septic shock, bacteria, specifically Staphylococcus aureus...
How does distributive shock occur?
The mechanism of distributive shock depends on the type of distributive shock. Septic shock occurs when bacteria produce toxins that damage the sma...
What are signs and symptoms of distributive shock?
The signs and diagnosis of distributive shock can be ascertained through careful and directed history-taking by a physician. Pertinent information...
How is distributive shock treated?
Distributive shock is a life threatening condition and should be treated immediately. The individual is typically admitted to an intensive care uni...
What are the most important facts to know about distributive shock?
Distributive shock is a life threatening event that results from lack of adequate blood flow and blood pressure throughout the body, and loss of bl...
What are the roles of inflammatory mediators in distributive shock?
Pathophysiology. In most cases, inflammatory mediators play a major role in the development of distributive shock. Inflammatory cytokines released in both sepsis and toxic shock syndrome induce systemic vasodilation and capillary leak, as well as cardiomyopathy.
What is distributive shock?
Introduction. Distributive shock, also known as vasodilatory shock, is one of the four broad classifications of disorders that cause inadequate tissue perfusion. Systemic vasodilation leads to decreased blood flow to the brain, heart, and kidneys causing damage to vital organs. Distributive shock also leads to leakage of fluid from capillaries ...
What happens to the blood flow in distributive shock?
In distributive shock, systemic vasodilation leads to decreased blood flow to the brain, heart, and kidneys damaging vital organs. Additionally, fluid leaks from the capillaries into the surrounding tissues, further complicating the clinical picture. further complicating the clinical picture.
What is the initial pressor for septic shock?
In septic shock, the initial pressor of choice is norepinephrine (2 mcg/min to 20 mcg/min), as this offers both alpha-1 and beta-1 stimulation, which will increase peripheral vasoconstriction without significantly compromising cardiac output.
What is cortisol in the body?
Cortisol is a key regulator of the expression of alpha-1 receptors on the arteriolar surface, but this becomes compromised in patients with adrenal insufficiency. In effect, the factors leading to vasodilation and shock are multimodal and complex.
What is neurogenic shock?
Neurogenic shock classically occurs in cases of trauma involving the cervical spinal cord. The sympathetic nervous system is damaged resulting in a decreased adrenergic input to the blood vessels and heart, causing vasodilation with resultant hypotension and paradoxical bradycardia.
What receptors do norepinephrine and epinephrine stimulate?
Both norepinephrine and epinephrine stimulate alpha-1 receptors on arterioles to cause vasoconstriction and regulate blood pressure. In the case of neurogenic shock, the sympathetic nervous system is compromised, leading to reduced catecholamine delivery to these receptors.
What is a Class III shock?
Class III: there are stagnant capillaries next to capillaries with normal blood flow. Class IV: hyperdynamic flow in capillaries adjacent to capillaries that are stagnant. Class V: widespread hyperdynamic flow in the microcirculatory system. According to the cause, there are 4 types of distributive shock: Neurogenic shock: Decreased sympathetic ...
What is neurogenic shock?
Rupture of a hollow organ, with subsequent evacuation of contents in the peritoneal cavity could also determine neurogenic shock, a subtype of distributive shock.
What are the different types of distributive shock?
According to the cause, there are 4 types of distributive shock: Neurogenic shock: Decreased sympathetic stimulation leading to decreased vasal tone. Anaphylactic shock. Septic shock.
What causes distributive shock?
Causes. In addition to sepsis, distributive shock can be caused by systemic inflammatory response syndrome (SIRS) due to conditions other than infection such as pancreatitis, burns or trauma. Other causes include, toxic shock syndrome (TSS), anaphylaxis (a sudden, severe allergic reaction), adrenal insufficiency, reactions to drugs or toxins, ...
What is the medical term for a condition where there is not enough oxygen in the blood?
Distributive shock. Distributive shock is a medical condition in which abnormal distribution of blood flow in the smallest blood vessels results in inadequate supply of blood to the body's tissues and organs. It is one of four categories of shock, a condition where there is not enough oxygen -carrying blood to meet the metabolic needs ...
What is hydrocortisone used for?
Hydrocortisone is used for people whose hypotension does not respond to fluid resuscitation and vasopressors. Opening and keeping open the microcirculation is a consideration in the treatment of distributive shock, as a result limiting the use of vasopressors has been suggested.
What causes inadequate tissue perfusion?
The cause of inadequate tissue perfusion (blood delivery to tissues) in distributive shock is a lack of normal responsiveness of blood vessels to vasoconstrictive agents and direct vasodilation. There are four types of distributive shock. The most common, septic shock, is caused by an infection, most frequently by bacteria, but viruses, ...
What is the role of inflammatory mediators in distributive shock?
Distributive shock pathophysiology. In most cases, inflammatory mediators play a major role in the development of distributive shock. Inflammatory cytokines released in both sepsis and toxic shock syndrome induce systemic vasodilation and capillary leak, as well as cardiomyopathy. The systemic release of histamine in anaphylaxis results in similar ...
What is distributive shock?
Distributive shock. Distributive shock also known as vasodilatory shock, results from excessive vasodilation and the impaired distribution of blood flow 1). Systemic vasodilation leads to decreased blood flow to the brain, heart, and kidneys causing damage to vital organs. Distributive shock also leads to leakage of fluid from capillaries into ...
Why is vasopressin depressed?
As shock continues, endogenous vasopressin levels may be depressed, perhaps due to depletion of the stores or impaired hypophyseal function in the setting of infection. This contributes to refractory hypotension 30). In this setting of hypotension, treatment with exogenous vasopressin has a role.
What is neurogenic shock?
Neurogenic shock classically occurs in cases of trauma involving the cervical spinal cord. The sympathetic nervous system is damaged resulting in a decreased adrenergic input to the blood vessels and heart, causing vasodilation with resultant hypotension and paradoxical bradycardia.
What is cortisol in the body?
Cortisol is a key regulator of the expression of alpha-1 receptors on the arteriolar surface, but this becomes compromised in patients with adrenal insufficiency. In effect, the factors leading to vasodilation and shock are multimodal and complex.
What is shock syndrome?
Shock is a clinical syndrome characterized by inadequate tissue perfusion that results in end-organ dysfunction. It can be divided into the following four categories 6): Distributive shock (vasodilation), which is a hyperdynamic process. Cardiogenic shock (pump failure)
What causes shock in the body?
A common cause is the systemic inflammatory response syndrome due to noninfectious causes such as pancreatitis and burns.
What are the different types of distributive shock?
According to the cause, there are 4 types of distributive shock: Neurogenic shock: Decreased sympathetic stimulation leading to decreased vasal tone. Anaphylactic shock. Septic shock. Shock due to adrenal crisis.
What are the different types of shock?
There are four major types of shock, each of which can be caused by a number of different events. Obstructive shock. Obstructive shock occurs when blood can't get where it needs to go. Cardiogenic shock. Distributive shock.
What is the shock code for septic shock?
Distributive shock codes to 998.00, with or without clarification. If it's not septic, it's not sepsis.
Why does levophed cause shock?
He states that the cause of this type of shock in a post-surgical patient is mostly likely due to vasodilation where the volume to fill becomes greater, thus, blood pressure drops. Levophed is used to help constrict the blood vessels and helps increase the blood pressure.
Can you have distributive shock without post op?
You can have distributive shock without being post op. Per the coders here and using the Encoder, there is no choice for distributive shock (the Encoder will not allow you to spell distributive) with the only choice being "other specified shock" which is 785.59, an MCC. "Shock unspecified" is 785.50, a CC.
Can you take septic shock with sepsis?
SIRS is an inflammatory response that can occur with or without sepsis, so if the physician states that it's distributive shock due to SIRS, but doesn't indicate the presence of infection--which appears to be the case in your scenario--you can't and shouldn't take it to septic shock.
Overview
Distributive shock is a medical condition in which abnormal distribution of blood flow in the smallest blood vessels results in inadequate supply of blood to the body's tissues and organs. It is one of four categories of shock, a condition where there is not enough oxygen-carrying blood to meet the metabolic needs of the cells which make up the body's tissues and organs. Distributive shock is different from the other three categories of shock in that it occurs even though the output of the …
Types
Elbers and Ince have identified five classes of abnormal microcirculatory flow in distributive shock using side stream dark field microscopy.
• Class I: all capillaries are stagnant when there is normal or sluggish venular flow.
• Class II: there are empty capillaries next to capillaries that have flowing red blood cells.
Causes
In addition to sepsis, distributive shock can be caused by systemic inflammatory response syndrome (SIRS) due to conditions other than infection such as pancreatitis, burns or trauma. Other causes include, toxic shock syndrome (TSS), anaphylaxis (a sudden, severe allergic reaction), adrenal insufficiency, reactions to drugs or toxins, heavy metal poisoning, hepatic (liver) insufficiency and damage to the central nervous system. Causes of adrenal insufficiency leadin…
Pathophysiology
The cause of inadequate tissue perfusion (blood delivery to tissues) in distributive shock is a lack of normal responsiveness of blood vessels to vasoconstrictive agents and direct vasodilation.
There are four types of distributive shock. The most common, septic shock, is caused by an infection, most frequently by bacteria, but viruses, fungi and parasites have been implicated. Infection sites most likely to lead to septic shock are chest, abdomen and genitourinary tract. In s…
Treatment
The main goals of treatment in distributive shock are to reverse the underlying cause and achieve hemodynamic stabilization. Immediate treatment involves fluid resuscitation and the use of vasoactive drugs, both vasopressors and inotropes. Hydrocortisone is used for people whose hypotension does not respond to fluid resuscitation and vasopressors. Opening and keeping open the microcirculation is a consideration in the treatment of distributive shock, as a result limiting …
Prognosis
Septic shock is associated with significant mortality and is the leading non-cardiac cause of death in intensive care units (ICUs).
Research directions
The choice of fluids for resuscitation remains an area of research, the Surviving Sepsis Campaign an international consortium of experts, did not find adequate evidence to support the superiority crystalloid fluids versus colloid fluids. Drugs such as, pyridoxalated hemoglobin polyoxyethylene, which scavenge nitric oxide from the blood have been investigated. As well as methylene blue which may inhibit the nitric oxide-cyclic guanosine monophosphate (NO-cGMP) pathway which …
External links
• Surviving Sepsis Campaign