SlideShare a Scribd company logo
1 of 11
Circulatory  shock It is a syndrome characterized by serious reduction of tissue perfusion with inadequate cardiac output. Shock is a condition characterized by inadequate delivery of oxygen and nutrients to critical organs such as heart, brain, liver, kidney and GIT. Types and causes of shock Depending upon cause of inadequate cardiac output the circulatory shock is divided into 4 types: Hypovolaemic shock Vasogenic shock Cardiogenic shock Obstructive shock
1. Hypovolaemic shock: It occurs due to low blood volume resulting in decreased cardiac output. Depending on causes this shock is divided into following types: Haemorrhagic shock: result as a internal or external blood loss due to ruptured blood vessels. Dehydration shock: due to dehydration circulatory blood volume reduces. Traumatic shock: trauma or injury  which produce severe pain which inhibits vasomotor center in medulla oblongata.
2. Vasogenic shock: It occurs due to toxic substances released by pathogens which leads to excessive vasodilation within the vessels. Depending upon causes vasogenic shock is divided in to following types: Neurogenic shock: occurs when nerves decreases sympathetic vasomotor tone and increase in vagal tone. Anaphylactic shock: it refers to acute allergic reaction in which large quantities of histamine releases. This histamine causes vasodilation of blood vessels leads to shock. Septicaemic shock: it is a condition in which bacteria circulate and multiply in the blood and form toxic products and cause high fever and vasodilation.
3. Cardiogenic shock: It occurs due to decreased pumping ability of the heart because of cardiac abnormality. Causes of this shock are: Myocardial Infarction Cardiac arrhythmia Congestive Cardiac Failure
4. Obstructive shock: It occurs due to impairment of ventricular filling during diastole due to some external pressure on the heart. Due to decreased ventricular filling stroke volume and hence cardiac output decreases. Causes of this shock are: Pericardial cardiac temponade means bleeding into the pericardium with external pressure on the heart. Pulmonary embolism: embolus formation occurs in the pulmonary vein so that no blood reaches to left heart.
Stages and clinical features of the shock: Depending upon severity circulatory shock is divided into 3 categories: First stage or non-progressive shock:it is also known as compensatory shock in which body try to compensate the loss of blood to vital organs with few mechanisms like: Rapid compensatory mechanism – baroreceptor reflex, chemoreceptor reflex, CNS ischemic response. Inter-mediate compensatory mechanism – renin angiotensin system, capillary fluid shift mechanism Long term compensatory mechanism – restoration of plasma volume and proteins, restoration of red cell mass. 2.Second stage or progressive shock: here compensatory mechanisms are not able to stop progression of shock and some positive feedback mechanism occurs which can lead to serious damage. 3.	Third stage or irreversible shock: all treatment becomes ineffective and patient dies due to severe tissue damage to the vital organs of the body.
Treatment of shock General treatment:  Patient should be kept in cold because exposed to warmth can cause sweating which can lead to hypovolemia and aggravate shock. Raising foot end of the patient bed by 6 to 12” which helps in promoting venous return and cardiac output increases. Replacement therapy: In hemorrhagic shock and burns whole blood or plasma or plasma substitute like dextran can be transfused. In hypovolemic shock due to dehydration balanced electrolyte solution (Intravenous Ringer Lactate solution) can be given. Sympathomimetic drugs: Helpful in neurogenic and anaphylactic shock where either sympathetic tone is low or vasodilation is present. Drugs like dopamine should be used if it is not available epinephrine and norepinephrine can also be used.  Oxygen therapy: Little bit helpful because it relieves hypoxia

More Related Content

What's hot

What's hot (20)

The coronary circulation
The coronary circulationThe coronary circulation
The coronary circulation
 
Cardiac cycle
Cardiac cycle   Cardiac cycle
Cardiac cycle
 
Coronary circulation
Coronary circulationCoronary circulation
Coronary circulation
 
#Cardiac output, venous return,and their regulation
#Cardiac output, venous return,and their regulation#Cardiac output, venous return,and their regulation
#Cardiac output, venous return,and their regulation
 
CORONARY CIRCULATION
CORONARY CIRCULATIONCORONARY CIRCULATION
CORONARY CIRCULATION
 
Circulatory shock
Circulatory shockCirculatory shock
Circulatory shock
 
Arterial blood pressure
Arterial blood pressureArterial blood pressure
Arterial blood pressure
 
Heart*
Heart*Heart*
Heart*
 
Hypoxia
HypoxiaHypoxia
Hypoxia
 
Blood coagulation
Blood coagulationBlood coagulation
Blood coagulation
 
Cardiac output 2
Cardiac output 2Cardiac output 2
Cardiac output 2
 
Neural regulation of Respiration
Neural regulation of RespirationNeural regulation of Respiration
Neural regulation of Respiration
 
Cardiac output
Cardiac outputCardiac output
Cardiac output
 
Cardiac output (The Guyton and Hall Physiology)
Cardiac output (The Guyton and Hall Physiology)Cardiac output (The Guyton and Hall Physiology)
Cardiac output (The Guyton and Hall Physiology)
 
Cardiac output & factors affecting it.
Cardiac output &  factors affecting it.Cardiac output &  factors affecting it.
Cardiac output & factors affecting it.
 
Cardiac muscle physiology
Cardiac muscle physiologyCardiac muscle physiology
Cardiac muscle physiology
 
Conduction system of the heart
Conduction system of the heartConduction system of the heart
Conduction system of the heart
 
Coagulation cascade
Coagulation cascadeCoagulation cascade
Coagulation cascade
 
The Cardiac Cycle
The Cardiac CycleThe Cardiac Cycle
The Cardiac Cycle
 
Development of the heart
Development of the heartDevelopment of the heart
Development of the heart
 

Viewers also liked

Viewers also liked (20)

Shock - Pathophysiology / Types & Management
Shock - Pathophysiology / Types & ManagementShock - Pathophysiology / Types & Management
Shock - Pathophysiology / Types & Management
 
Circulatory shock
Circulatory shockCirculatory shock
Circulatory shock
 
Shock
Shock	Shock
Shock
 
Circulatory shock
Circulatory shockCirculatory shock
Circulatory shock
 
shock
shockshock
shock
 
Circulatory Shock slideshare
Circulatory Shock slideshareCirculatory Shock slideshare
Circulatory Shock slideshare
 
SHOCK
SHOCKSHOCK
SHOCK
 
SHOCK
SHOCKSHOCK
SHOCK
 
Shock
ShockShock
Shock
 
Hypovolemic Shock
Hypovolemic ShockHypovolemic Shock
Hypovolemic Shock
 
Physiology shock
Physiology shockPhysiology shock
Physiology shock
 
Hypovolemic shock
Hypovolemic shock Hypovolemic shock
Hypovolemic shock
 
Diagnosis and Management of Shock
Diagnosis and Management of Shock		Diagnosis and Management of Shock
Diagnosis and Management of Shock
 
SHOCK
SHOCKSHOCK
SHOCK
 
Blood pressure regulation 2013
Blood pressure regulation 2013Blood pressure regulation 2013
Blood pressure regulation 2013
 
24)Bleeding And Shock
24)Bleeding And Shock24)Bleeding And Shock
24)Bleeding And Shock
 
Ch04 hemorrhage and shock
Ch04 hemorrhage and shockCh04 hemorrhage and shock
Ch04 hemorrhage and shock
 
Hemotology
HemotologyHemotology
Hemotology
 
Shock
ShockShock
Shock
 
Physiology and mli of shock
Physiology and mli of shockPhysiology and mli of shock
Physiology and mli of shock
 

Similar to Circulatory shock

Similar to Circulatory shock (20)

Shocks
ShocksShocks
Shocks
 
Shock by Dr. Fazal Abbas
Shock by Dr. Fazal AbbasShock by Dr. Fazal Abbas
Shock by Dr. Fazal Abbas
 
Shock and Management
Shock and  ManagementShock and  Management
Shock and Management
 
Shock - the life threatening condition
Shock - the life threatening conditionShock - the life threatening condition
Shock - the life threatening condition
 
Shock seminar 2016 anesthesia.........pptx
Shock seminar 2016 anesthesia.........pptxShock seminar 2016 anesthesia.........pptx
Shock seminar 2016 anesthesia.........pptx
 
Pathophysiology and management of shock
 Pathophysiology and management of shock Pathophysiology and management of shock
Pathophysiology and management of shock
 
Circulatory Shock.12345.............pptx
Circulatory Shock.12345.............pptxCirculatory Shock.12345.............pptx
Circulatory Shock.12345.............pptx
 
Shock
ShockShock
Shock
 
shock.pptx
shock.pptxshock.pptx
shock.pptx
 
Shock1
Shock1Shock1
Shock1
 
Shock
ShockShock
Shock
 
Shock
ShockShock
Shock
 
Pathology ( Shock )
Pathology ( Shock )Pathology ( Shock )
Pathology ( Shock )
 
Shock - Pathology - Allied health sciences
Shock - Pathology - Allied health sciencesShock - Pathology - Allied health sciences
Shock - Pathology - Allied health sciences
 
By adult health nursing of Shock ppt.pptx
By adult health nursing of Shock ppt.pptxBy adult health nursing of Shock ppt.pptx
By adult health nursing of Shock ppt.pptx
 
Physiology of Cardiovascular shock.
Physiology of Cardiovascular shock.Physiology of Cardiovascular shock.
Physiology of Cardiovascular shock.
 
Cardiogenic shock (4)
Cardiogenic shock (4)Cardiogenic shock (4)
Cardiogenic shock (4)
 
Shock .pptx
Shock .pptxShock .pptx
Shock .pptx
 
PATHOLOGY AND MANAGEMENT OF SHOCK
PATHOLOGY AND MANAGEMENT OF SHOCKPATHOLOGY AND MANAGEMENT OF SHOCK
PATHOLOGY AND MANAGEMENT OF SHOCK
 
Pathogenesis and Medicolegal aspect of shock
Pathogenesis and Medicolegal aspect of shock Pathogenesis and Medicolegal aspect of shock
Pathogenesis and Medicolegal aspect of shock
 

More from Lawrence James

More from Lawrence James (20)

Pharmacokinetics
PharmacokineticsPharmacokinetics
Pharmacokinetics
 
Bacteriology physiology
Bacteriology physiology Bacteriology physiology
Bacteriology physiology
 
Bacteriology physiology 1-mbbs-y2-5-oct2011---2
Bacteriology physiology 1-mbbs-y2-5-oct2011---2Bacteriology physiology 1-mbbs-y2-5-oct2011---2
Bacteriology physiology 1-mbbs-y2-5-oct2011---2
 
Bacteriology physiology 1-mbbs-y2-5-oct2011---2
Bacteriology physiology 1-mbbs-y2-5-oct2011---2Bacteriology physiology 1-mbbs-y2-5-oct2011---2
Bacteriology physiology 1-mbbs-y2-5-oct2011---2
 
Physiology syallabus
Physiology syallabusPhysiology syallabus
Physiology syallabus
 
Physio case study
Physio case studyPhysio case study
Physio case study
 
Physio case study
Physio case studyPhysio case study
Physio case study
 
Physio case study
Physio case studyPhysio case study
Physio case study
 
Regulation of respiration
Regulation of respirationRegulation of respiration
Regulation of respiration
 
Disturbances of respiration 2
Disturbances of respiration 2Disturbances of respiration 2
Disturbances of respiration 2
 
Lec16(cvs)
Lec16(cvs)Lec16(cvs)
Lec16(cvs)
 
Lec18(cvs)
Lec18(cvs)Lec18(cvs)
Lec18(cvs)
 
Cvs7
Cvs7Cvs7
Cvs7
 
Heart sounds
Heart soundsHeart sounds
Heart sounds
 
Blood supply of git
Blood supply of gitBlood supply of git
Blood supply of git
 
Urinary bladder and urethra
Urinary bladder  and urethraUrinary bladder  and urethra
Urinary bladder and urethra
 
Bony pelvis
Bony pelvisBony pelvis
Bony pelvis
 
Development of heart
Development of heartDevelopment of heart
Development of heart
 
Physio updated
Physio updatedPhysio updated
Physio updated
 
Joints upper limb 2nd lecture10122010
Joints upper limb 2nd lecture10122010Joints upper limb 2nd lecture10122010
Joints upper limb 2nd lecture10122010
 

Circulatory shock

  • 1. Circulatory shock It is a syndrome characterized by serious reduction of tissue perfusion with inadequate cardiac output. Shock is a condition characterized by inadequate delivery of oxygen and nutrients to critical organs such as heart, brain, liver, kidney and GIT. Types and causes of shock Depending upon cause of inadequate cardiac output the circulatory shock is divided into 4 types: Hypovolaemic shock Vasogenic shock Cardiogenic shock Obstructive shock
  • 2. 1. Hypovolaemic shock: It occurs due to low blood volume resulting in decreased cardiac output. Depending on causes this shock is divided into following types: Haemorrhagic shock: result as a internal or external blood loss due to ruptured blood vessels. Dehydration shock: due to dehydration circulatory blood volume reduces. Traumatic shock: trauma or injury which produce severe pain which inhibits vasomotor center in medulla oblongata.
  • 3. 2. Vasogenic shock: It occurs due to toxic substances released by pathogens which leads to excessive vasodilation within the vessels. Depending upon causes vasogenic shock is divided in to following types: Neurogenic shock: occurs when nerves decreases sympathetic vasomotor tone and increase in vagal tone. Anaphylactic shock: it refers to acute allergic reaction in which large quantities of histamine releases. This histamine causes vasodilation of blood vessels leads to shock. Septicaemic shock: it is a condition in which bacteria circulate and multiply in the blood and form toxic products and cause high fever and vasodilation.
  • 4. 3. Cardiogenic shock: It occurs due to decreased pumping ability of the heart because of cardiac abnormality. Causes of this shock are: Myocardial Infarction Cardiac arrhythmia Congestive Cardiac Failure
  • 5. 4. Obstructive shock: It occurs due to impairment of ventricular filling during diastole due to some external pressure on the heart. Due to decreased ventricular filling stroke volume and hence cardiac output decreases. Causes of this shock are: Pericardial cardiac temponade means bleeding into the pericardium with external pressure on the heart. Pulmonary embolism: embolus formation occurs in the pulmonary vein so that no blood reaches to left heart.
  • 6. Stages and clinical features of the shock: Depending upon severity circulatory shock is divided into 3 categories: First stage or non-progressive shock:it is also known as compensatory shock in which body try to compensate the loss of blood to vital organs with few mechanisms like: Rapid compensatory mechanism – baroreceptor reflex, chemoreceptor reflex, CNS ischemic response. Inter-mediate compensatory mechanism – renin angiotensin system, capillary fluid shift mechanism Long term compensatory mechanism – restoration of plasma volume and proteins, restoration of red cell mass. 2.Second stage or progressive shock: here compensatory mechanisms are not able to stop progression of shock and some positive feedback mechanism occurs which can lead to serious damage. 3. Third stage or irreversible shock: all treatment becomes ineffective and patient dies due to severe tissue damage to the vital organs of the body.
  • 7.
  • 8.
  • 9.
  • 10.
  • 11. Treatment of shock General treatment: Patient should be kept in cold because exposed to warmth can cause sweating which can lead to hypovolemia and aggravate shock. Raising foot end of the patient bed by 6 to 12” which helps in promoting venous return and cardiac output increases. Replacement therapy: In hemorrhagic shock and burns whole blood or plasma or plasma substitute like dextran can be transfused. In hypovolemic shock due to dehydration balanced electrolyte solution (Intravenous Ringer Lactate solution) can be given. Sympathomimetic drugs: Helpful in neurogenic and anaphylactic shock where either sympathetic tone is low or vasodilation is present. Drugs like dopamine should be used if it is not available epinephrine and norepinephrine can also be used. Oxygen therapy: Little bit helpful because it relieves hypoxia