SHOCKMULTIPLE ORGAN FAILURE SUBENDOCARDIAL HEMORRHAGE ACUTE TUBULAR NECROSIS DAD (Diffuse Alveolar Damage, lung) GI MUCOSAL HEMORRHAGES LIVER NECROSIS DIC

MULTIPLE ORGAN FAILURE
SUBENDOCARDIAL HEMORRHAGE
ACUTE TUBULAR NECROSIS
DAD (Diffuse Alveolar Damage, lung)
GI MUCOSAL HEMORRHAGES
LIVER NECROSIS
DIC

1. SHOCK

2. DEFINITION Shock is defined as a condition where the tissues in the body don't receive enough oxygen and nutrients to allow the cells to function.

3. TYPES Hypovolemic shock - It occurs due to intravascular fluid volume. Cardiogenic shock- I t occurs due to systolic or diastolic dysfunction. Septic shock Anaphylactic shock Neurogenic shock

4. RISK FACTOR Preexisting myocardial damage Diabetes mellitus Advanced age Previous MI Dysarythmia

5. causes MI Valvular regurgitation Acute myocarditis Cardiomyopathy Cardiac tamponade Pulmonary embolism

6. CARDIOGENIC SHOCK C STRUCTURAL DEFECTS IN HEART, DYSARYTHMIAS ETC. SYSTOLIC & DIASTOLIC DYSFUNCTION DECREASED CARDIAC OUTPUT & INCREASED P\JLMONARY PRESSURE PULMONARY EDEMA DECREASED CELLULAR OXYGEN SUPPLY DECREASED TISSUE PERFUSION

7. HYPOVOLEMIC SHOCK DECREASED BLOOD VOLUME DUE TO ACCIDENT/BURN ETC. DECREASED VENOUS RETURN DECREASED CARDIAC OUTPUT DECREASED TISSUE PERFUSION DECREASED CELLULAR METABOLISM

8. NEUROGENIC SHOCK DISRUPTION OF SYMPATHETIC NERVOUS SYSTEM VASODILATION DECREASED BP DECREASED CARDIAC OUTPUT DECREASED TISSUE PERFUSION IMPAIRED CELLULAR METABOLISM

9. ANAPHYLACTIC SHOCK ALLERGAN , DRUG ETC. ANTIGEN ANTIBODY REACTION VASODILATION CAPILLARY PERMEABILITY SEVERE BRONCHO CONSTRICTION DECREASED OXYGEN SUPPLY AND UTILIZATION INADEQUATE TISSUE PERFUSION

10. CLINICAL MANIFESTATION Low blood pressure Moist, clammy skin Unconsciousness Rapid, shallow breathing Feeling anxious, agitated or confused Cyanosis

11. STAGES OF SHOCK Initial non progressive Progressive stage Irreversible stage

12. STAGES OF SHOCK Initial non progressive stage –Compensatory mechanism Progressive stage – Non compensatory stage, vital organs show effect of hypoxia Irreversible stage- Failure to restore circulation either after compensatory mechanism or by therapeutic intervention

13. COMPLICATIONS Loss of consciousness Respiratory failure Coagulation disorder Multi organ damage Coma Death

14. PATHOLOGY MULTIPLE ORGAN FAILURE SUBENDOCARDIAL HEMORRHAGE ACUTE TUBULAR NECROSIS DAD (Diffuse Alveolar Damage, lung) GI MUCOSAL HEMORRHAGES LIVER NECROSIS DIC

15. ARDS/DAD

16. MYOCARDIAL NECROSIS

17. ATN

18. DIC

19. CLINICAL PROGRESSION of SYMPTOMS Hypotension  Tachycardia  Tachypnea  Warm skin  Cool skin Cyanosis Renal insufficiency Obtundance Death