What is Shock ?

What is Shock

Clinical syndrome caused by inadequate tissue hemorrhage And between the supply and demand of oxygen, which is a supportive factor Cellular function, disorder occurs.

If there is enough blood to reach the cells, there must be several conditions. Each of the following conditions, which is disturbed, also affects the tissue Disrupted:
Effective pumping of heart
Vascular System (Blood Flow)
Effective Good blood volume

Physiology of cell function

Energy metabolism in the cell as food breaks down They are stored in ATP form. The energy stored in the cell in essential functions such as Transition activation, muscle contraction, conduction of electrical impulses and … it helps.
ATP is produced in two aerobic (in the presence of O2) and anaerobic Gets In the aerobic type, the production of ATP is greater than production Toxic substances, such as acid, are absent.

What is Shock

Shock steps

Elementary: 1 stage
Compensation: 2 steps
Advanced: 3 steps
Irreversible: Step 4

Elementary stage

Reduced tissue perfusion and hypoxia as a result of the onset of metabolism Anaerobic, the production of alkaline acids in and out of the cell and ultimately Metabolic acidosis Correction of these processes by the liver, which also has hypoxia Is.

Compensatory stage

The activation of physiological mechanisms, including the nervous system, Hormone and biochemicals to compensate for the reduction of perfusion  Hypothyroidism and CO2 removal and as a result of acidosis Reducing blood flow and stimulating the arterial baroreceptors; Stimulation of sympathetic system and production of epinephrine and norepinephrine, contraction Vascular, increased number and cardiac contractility for boosting blood pressure And out of the heart  activation of renin-angiotensin-aldosterone system, secretion ADH hormone, increased water reabsorption from the kidneys and fluid retention The result is an increase in blood volume and elevated blood pressure

Clinical protests

Compensation for respiratory acidosis by the lung and with metabolic alkalosis (The cause of increased respiration and high CO2 emissions) Changes in mental conditions, anxiety and confusion If treated at this stage: Prognosis is better than the stages The next is to prevent progress towards the next steps It turns out.

Advanced stage

In the absence of treatment and the continuation of pathologic processes, failure Compensatory mechanisms Cell hypoxia, sodium invasion into the cell and potassium excretion It’s  Failure of the valves leading to acidosis and reduced return Intravenous, increased hydrostatic pressure, release of histamine and Increase vein permeability, fluid outflow and protein to outer space Veins and edema

Clinical protests

Reducing oxygen supply to the brain, reducing consciousness Reducing oxygen supply to the heart, chest pain With fast and correct treatment, this stage can also be compensated He treated the shock.

Irreversible stage

With continued inadequate perfusion and severe hypoxia, cardiac function decreases The finding also reduces cardiac output. The kidneys progress to the defect (oliguria and anuria). Cells in all organs depending on their resistance to Hypoxia is damaged, die and also with cell death Loses his life.

Hypovolemic shock

The most common type of shock It occurs in the reduction of circulating blood volume. Causes: Diarrhea, vomiting, bleeding, excessive urination in diabetes mellitus or Diabetes mellitus and kidney failure, severe burns, bowel obstruction, pancreatic inflammation, and … The most common cause: bleeding from trauma and gastrointestinal bleeding In general, loss of more than 20-25% of blood volume (per person) 70 A kilogram of about 1 liter of blood can cause shock.

Cardiogenic shock

The pathologic process that often leads to death (at 80-50%) Items(Cause: Any illness or event that reduces the power of the muscular cells of the heart As a result, the amount of heart pumping decreases to deliver adequate blood to the organs of the body To give Causes: myocardial infarction, inflammation of the heart muscle (myocarditis), arrhythmias, Heart valve abnormalities The most common cause: MI when 40-30% of myocardial muscle is disabled.

Septic shock

When the infections are treated to the untreated or incomplete body as a result It progresses and affects the organs of the body. Agent: Gram-negative bacteria such as Escherichia coli, Proteus or Klebsia They produce endotoxins or gram-positive bacteria, such as pneumococci and Streptococci or fungi that produce endotoxin. Toxins produced by bacteria and spread in the blood

Neurogenic shock

The Most Rarest Shock In most cases caused by trauma to the spinal cord Can also be caused by spinal anesthesia. In contrast to hypovolemic shock, which reduces the intravascular fluidity in this The type of fluid shock in the arteries remains due to vascular dilatation and reduction The return of venous blood is caused by shock signs.

Anaphylactic shock

Caused by incompatible reactions to an allergen, antigen, drug and Or an alien protein High levels of release of histamine, severe vasodilatation, increased permeability The vessels and the discharge of fluids from the vessels to the outside, reducing blood pressure and disturbance of perfusion Texture

Obstructive shock

In this type of shock, there is an obstruction in the bloodstream that causes the disorder Circulatory and cardiac arrest.

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