Pathogenesis of shock in field of dentistry

Shock is a critical condition brought on by the sudden drop in blood flow through the body. Shock may result from trauma, heatstroke, blood loss or an allergic reaction. It also may result from severe infection, poisoning, severe burns or other causes.

Shock keeps organs from getting enough blood or oxygen. If shock is not treated, it can lead to permanent organ damage or even death.Shock is a critical condition brought on by the sudden drop in blood flow through the body. Shock may result from trauma, heatstroke, blood loss or an allergic reaction. It also may result from severe infection, poisoning, severe burns or other causes.

Shock keeps organs from getting enough blood or oxygen. If shock is not treated, it can lead to permanent organ damage or even death.Shock is a critical condition brought on by the sudden drop in blood flow through the body. Shock may result from trauma, heatstroke, blood loss or an allergic reaction. It also may result from severe infection, poisoning, severe burns or other causes.

Shock keeps organs from getting enough blood or oxygen. If shock is not treated, it can lead to permanent organ damage or even death.Shock is a critical condition brought on by the sudden drop in blood flow through the body. Shock may result from trauma, heatstroke, blood loss or an allergic reaction. It also may result from severe infection, poisoning, severe burns or other causes.

Shock keeps organs from getting enough blood or oxygen. If shock is not treated, it can lead to permanent organ damage or even death.Shock is a critical condition brought on by the sudden drop in blood flow through the body. Shock may result from trauma, heatstroke, blood loss or an allergic reaction. It also may result from severe infection, poisoning, severe burns or other causes.

Shock keeps organs from getting enough blood or oxygen. If shock is not treated, it can lead to permanent organ damage or even death.Shock is a critical condition brought on by the sudden drop in blood flow through the body. Shock may result from trauma, heatstroke, blood loss or an allergic reaction. It also may result from severe infection, poisoning, severe burns or other causes.

Shock keeps organs from getting enough blood or oxygen. If shock is not treated, it can lead to permanent organ damage or even death.Shock is a critical condition brought on by the sudden drop in blood flow through the body. Shock may result from trauma, heatstroke, blood loss or an allergic reaction. It also may result from severe infection, poisoning, severe burns or other causes.

Shock keeps organs from getting enough blood or oxygen. If shock is not treated, it can lead to permanent organ damage or even death.Shock is a critical condition brought on by the sudden drop in blood flow through the body. Shock may result from trauma, heatstroke, blood loss or an allergic reaction. It also may result from severe infection, poisoning, severe burns or other causes.

Shock keeps organs from getting enoug

1. SHOCK

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3. DEFINATION Shock is  characterised  by systemic hypoperfusion; it can be caused by diminished cardiac output or by reduced effective circulating blood volume.The consequences are impaired tissue perfusion and cellular hypoxia Shock is the clinical syndrome that results from  inadaquate  tissue perfusion 8/11/2024 3

4. TYPES OF SHOCK 1.HYPOVOLEMIC SHOCK 2.CARDIOGENIC SHOCK  3.NEUROGENIC SHOCK 4.SEPTIC SHOCK 8/11/2024 4

5. HYPOVOLEMIC SHOCK MOST COMMON FORM OF SHOCK OCCURS DUE TO DECEASED BLOOD  OR PLASMA VOLUME EXAMPLES HEMORRHAGE VOMITING DIARRHEA BURNS TRAUMA 8/11/2024 5

6. HEMORRHAGIC SHOCK DIVIDED INTO 4 TYPES 1.<1000ml: COMPENSATED 2.1000-1500ml: MILD 3.1500-2000ml: MODERATE 4.>2000 ml: SEVERE 8/11/2024 6

7. CARDIOGENIC SHOCK CAUSED BY FAILURE OF MYOCARDIAL PUMP EXAMPLES MYOCARDIAL INFACTION VENTRICULAR RUPTURE ARRHYTHMIA CARDIAC TEMPONADE PULMONARY EMBOLISM 8/11/2024 7

8. SUBSET OF SEPSIS IN WHICH PARTICULARLY THERE IS PROFOUND CIRCULATORY;CELLULAR & METABOLIC ABNORMALITIES EXAMPLES   MICROBIAL NON MICROBIAL OVERHELMING BACTERIAL /FUNAL INFECTION TRAUMA SUPER ANTIGENS [TOXIC SHOCK SYNDROME] BURNS   PANCETITIS 8/11/2024 8 SEPTIC SHOCK

9. PATHOGENESIS OF SEPTIC SHOCK 8/11/2024 9 MICROBIAL CONSTITUENTS STIMULATE INFLAMMATORY CELLS {INNATE IMMUNE SYSTEM} LEADS TO  MASSIVE OUTPOURING OF MEDIATORS  LIKE    1.INFLAMMATORY RESPONS  2.ENDOTHELIAL ACTIVATION 3.INDUCTION OF PROCOAGULATION 4.METABOLIC ABNORMALITIES  

10. INFLAMMATORY AND COUNTER INFLAMMATORY RESPONSE ACTIVATION OF INNATE IMMUNITY COMPLIMENT ACTIVATION ACTIVATION OF COAGULATION ACTIVATION OF THROMBIN COUNTER INFLAMMATORY EFFECTS 8/11/2024 10

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12. MICROBIAL PRODUCTS   ACTIVATES COMPLIMENTARY CASCADE   C3a;c5a [anaphylatoxins] C5a [chemotactic fragments] C3b [ opsonins ] 8/11/2024 12

13. ACTIVATION OF COAGULATION 8/11/2024 13

14. ACCOMPAYING WIDESPREAD ACTIVATION OF THROMBIN STIMULATE PROTEASE ACTIVATED RECEPTOR HYPER INFLAMMATORY STATE TRIGGERS STIMULATE COUNTER REGULATORY IMMUNOSUPRESSIVE MECHANISM SHIFT FROM PRO INFLAMMATORY CYTOKINES TO ANTI INFLAMMATORY CYTOKINES 8/11/2024 14

15. 1.PRODUCTION OF ANTI INFLAMMATORY MEDIATORS 2.LYMPHOCYTE APOPTOSIS 3.CELLULAR ENERGY 8/11/2024 15

16. ENDOTHELIAL ACTIVATION AND INJURY ENDOTHELIAL ACTIVATION INCREASE VASCULAR INCEASE NO;C5a MICROVASCULAR PERMEABILITY & DYSFUNCTION TISSUE EDEMA VASCULAR SMOOTH RELAXATION ALTERATION OF BLOOD IMPAIRED TISSUE FLOW IN CAPILLARIES  PERFUSION  SYSTEMIC HYPOTENSION MISMATCH IN O2 NEED & DELIVERY 8/11/2024 16

17. INDUCTION OF PROCOAGULABLE STATE 50% OF PATIENTS DEVELOP INCREASED PROCOAGULANT DECREASED PRODUCTION OF   FACTORS   ANTICOAGULANT FACTORS ALSO INCREASES ANTIFIBYNOLYTIC EFFECT 8/11/2024 17

18. PATHOGENESIS OF SEPTIC SHOCK 8/11/2024 18

19. STAGES OF SHOCK SEPTIC SHOCK  PATHWAY OF SEPTIC SHOCK IS UNCLEAR WITH NO UNDEFINED STAGES DEATH OCCUR DUE TO 1.MULTIORGAN FAILURE  SECONDARY TO EDEMA 2. TISSUE HYPOXIA 8/11/2024 19

20. HYPOVOLEMIC  & CARDIOGENIC SHOCK THROUGH 3 STAGES 1.NON PROGRESSIVE STAGE: REFLEX COMPENSATORY MECHANISM ACTIVATED &PERFUSION OF VITAL ORGANS MAINTAINED 2.PROGRESSIVE STAGE CHARACTERISED BY TISSUE HYPOPERFUSION & ONSET OF WORSENING      CIRCULATORY & METABOLIC DEARRANGEMENTS INCLUDING ACIDOSIS 8/11/2024 20

21. 3 . IRREVERSIBLE STAGE CELLULAR / TISSUE INJURY EVEN IF HEMODYNAMIC DEFECTS ARE CORRECTED SURVIVAL NOT POSSIBLE  8/11/2024 21

22. FEATURES FEATURES HYPOVOLEMIC CARDIAC SEPTIC Cardiac output Systolic blood pressure Heart rate Jugular venous pressure NORMAL Pulmpmary capillary wedge pressure NORMAL Peripheral vascular resistance Skin temp 8/11/2024 22