How is distributive shock different from other types of shock?
Distributive shock is different from the other three categories of shock in that it occurs even though the output of the heart is at or above a normal level. The most common cause is sepsis leading to type of distributive shock called septic shock, a condition that can be fatal.
What is the most common type of shock?
Distributive shock is the most common of the four types of shock, with the others being hypovolemic, cardiogenic and obstructive shock. Each year, 1 million Americans get septic shock, which is the top cause of distributive shock. It can affect anyone. How does distributive shock affect my body?
What is distributive shock from sepsis?
Septic shock from sepsis makes up the largest number of cases, but people also get distributive shock from severe allergic reactions or asthma attacks. Quick treatment is very important, as it gives you the best odds of survival. Excessively relaxed blood vessels in distributive shock are unable to deliver enough blood.
What is the new classification of shock?
Conclusion The new classification is intended to facilitate the goal-driven treatment of shock in both the pre-hospital and the inpatient setting. A uniform treatment strategy should be established for each of the four types of shock.
What is the most common type of disruptive shock?
There are three subcategories of distributive shock: septic shock, anaphylactic shock, and neurogenic shock. Sepsis and septic shock are the most common forms of distributive shock and are typically caused by bacterial infection.
What are the 3 types of shock?
The main types of shock include: Cardiogenic shock (due to heart problems) Hypovolemic shock (caused by too little blood volume) Anaphylactic shock (caused by allergic reaction)
Is anaphylactic shock a type of distributive shock?
Anaphylactic shock: a form of distributive shock without inhibition of oxygen consumption.
What are the 4 types of shock?
There are mainly four broad categories of shock: distributive, hypovolemic, cardiogenic, and obstructive. [1] The wide range of etiologies can contribute to each of these categories and are manifested by the final outcome of shock.
Which of the following are types of distributive shock quizlet?
Distributive shock: Neurogenic Shock, Septic Shock, and Anaphylactic Shock Flashcards | Quizlet.
How is distributive shock diagnosed?
Cardinal features of distributive shock include the following: Change in mental status. Heart rate - Greater than 90 beats per minute (note that heart rate elevation is not evident if the patient is on a beta blocker) Hypotension - Systolic blood pressure less than 90 mm Hg or a reduction of 40 mm Hg from baseline.
What are the 3 distributive shocks?
Distributive shock The three subtypes are septic, anaphylactic/anaphylactoid, and neurogenic shock.
Which of the following is the most accurate definition of distributive shock?
Distributive shock is a condition in which the majority of blood is inappropriately distributed in the vasculature.
What causes hypovolemic shock?
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 are the 4 types of shock quizlet?
Terms in this set (4)Hypovolemic shock. is due to decreased blood volume.Cardiogenic shock. is due to poor heart function.vascular shock. is due to inappropriate vasodilation.obstructive shock. is due to obstruction of blood flow.
What are the 5 types of shock?
There are several types of shock: septic shock caused by bacteria, anaphylactic shock caused by hypersensitivity or allergic reaction, cardiogenic shock from heart damage, hypovolemic shock from blood or fluid loss, and neurogenic shock from spinal cord trauma. Treatment for shock depends on the cause.
What are the 7 types of shock?
18.9A: Types of ShockHypovolemic Shock.Cardiogenic Shock.Obstructive Shock.Distributive Shock.Septic.Anaphylactic.Neurogenic.
What is shock and its types?
The four major types are: obstructive shock. cardiogenic shock. distributive shock. hypovolemic shock.
How many types of shocks are there?
There are four subtypes of shock with differing underlying causes and symptoms: hypovolemic, cardiogenic, obstructive, and distributive. Distributive shock can be further divided into septic, anaphylaxis, and neurogenic shock.
What are the types of shock EMT?
There are five types of shock: cardiogenic, distributive, obstructive, dissociative and hemorrhagic.
What are the 8 main causes of shock?
What are the 8 main causes of shock?Heart conditions (heart attack, heart failure)Heavy internal or external bleeding, such as from a serious injury or rupture of a blood vessel.Dehydration, especially when severe or related to heat illness.Infection (septic shock)Severe allergic reaction (anaphylactic shock)More items...
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 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 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.
How much fluid perfusion is needed for distributive shock?
Regardless of the type of shock, the majority of patients will tolerate and benefit from an initial fluid bolus of 250-500 mL. Patients with distributive shock are significantly more likely to require vasopressor support. The ultimate goal is to achieve adequate tissue perfusion utilizing fluid resuscitation and vasopressors. This can be achieved by targeting a mean arterial pressure of greater than 65 mmHg, which is the approximate critical perfusion pressure for both the heart and kidneys. Adequacy of tissue perfusion can be monitored with multiple modalities, including physical exam, Scv02 greater than or equal to 70%, and laboratory parameters including lactate and base deficit. The pressor choice will vary depending on the suspected etiology of distributive shock. [11][12][13]
How much does distributive shock affect mortality?
The mortality from distributive shock varies on the cause and can range from 20-80%. Early recognition is the key to improved survival. Higher mortality rates are linked to:
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 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.
How many types of distributive shock are there?
According to the cause, there are 4 types of distributive shock:
How many classes of abnormal microcirculatory flow in distributive shock?
Elbers and Ince have identified five classes of abnormal microcirculatory flow in distributive shock using side stream dark field microscopy .
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 causes septic 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 septic shock the blood flow in the microvasculature is abnormal with some capillaries underperfused ...
What is the cause of low blood pressure in anaphylactic shock?
In anaphylactic shock low blood pressure is related to decreased systemic vascular resistance (SVR) triggered primarily by a massive release of histamine by mast cells activated by antigen -bound immunoglobulin E and also by increased production and release of prostaglandins.
What are the four types of shock?
Synoptic view of the four types of shock (inner, white field) with the organ systems primarily associated with them (outer corners), sites and mechanisms of manifestation (outside the circle), and pathogenetic and pathophysiologic features (outer and middle sectors of the circle). To maintain clarity, mixed types of shock are not depicted.
What is the common feature of all types of shock?
A severe mismatch between the supply and demand of oxygen is the common feature of all types of shock. We present a newly developed, clinically oriented classification of the various types of shock and their therapeutic implications.
What is a traumatized hypovolemic shock?
Traumatic hypovolemic shock, resulting from a critical reduction in circulating plasma volume without acute hemorrhage, due to soft tissue injury and the release of immune system mediators.
What is hypovolemic shock?
Hypovolemic shock is a condition of inadequate organ perfusion caused by loss of intravascular volume, usually acute. The result is a drop in cardiac preload to a critical level and reduced macro- and microcirculation, with negative consequences for tissue metabolism and the triggering of an inflammatory reaction.
How many subcategories are there in hypovolemic shock?
Of these, hypovolemic shock is divided into four subcategories and distributive shock into three. Obstructive shock has been given a category of its own. Although this nomenclature and classification is schematic and there is some overlapping between the main groups, these four main groups can be basically assigned to four organ systems (figure 1) that, owing to differences in their pathogenesis and pathophysiology, require group-specific—or, in other words, organ-specific—treatment (figure 2):
How many types of shock are there?
There are only four major categories of shock, each of which is mainly related to one of four organ systems. Hypovolemic shock relates to the blood and fluids compartment while distributive shock relates to the vascular system; cardiogenic shock arises from primary cardiac dysfunction; and obstructive shock arises from a blockage of the circulation.
What is hemorrhagic shock?
Traumatic hemorrhagic shock, resulting from acute hemorrhage with soft tissue injury and, in addition, release of immune system activators
What happens to the smooth muscle in shock?
Due to altered blood flow distribution. In septic and anaphylactic shock, vascular smooth muscle becomes incapable of constriction d/t endothelial insult. In neurogenic shock, there is loss of sympathetic nervous system response.
What does a patient with septic shock have?
A patient with septic shock has a high CO and tachycardia. The nurse recognizes that this combination of clinical signs suggests which type of shock?
What is the term for organ dysfunction, hypoperfusion, or hypotension?
Sepsis associated with organ dysfunction, hypo perfusion, or hypotension;
What is the systemic response to infection?
systemic response to infection triggers a series of cellular and humoral events. Pathogens and endotoxins stimulate the release of inflammatory mediators that impair microvasculature, resulting in increased capillary permeability and vasodilation.
Overview
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