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ID:5355758
大小:2.32 MB
页数:63页
时间:2017-12-08
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1、DevelopmentofshocktheoryDevelopmentofshocktheory1Shock-1743,firstputforward2Manifestation,firstdefined,18953Circulationaldisturbance-WWI,II4Microcirculationfailure-1960s5Cellular&molecularchanges-1980s&beyondWhatisShock???WhatisShock???Shockisafailureofthecirculatorysyst
2、emtoShockisafailureofthecirculatorysystemtomaintainadequateperfusionofvitalmaintainadequateperfusionofvitalorgans.organs.cellularhypoxiaanaerobiccellularmetabolismaccumulationofwasteproductsincellscellulardeathTypesofShockTypesofShockHypovolemicHypovolemicShockShockCardi
3、ogenicCardiogenicShockShockDistributive(Distributive(vasogenicvasogenic)Shock)Shock––NeurogenicNeurogenicshockshock––SepticshockSepticshock––AnaphylacticshockAnaphylacticshockSepticshockHypovolemicHypovolemicShockShockoccurswhenthereisalargereductioninoccurswhenthereisal
4、argereductioninthecirculatingbloodvolume.thecirculatingbloodvolume.----ActualActualhypovolemichypovolemicshockshock--lossofblood/fluidlossofblood/fluid----RelativeRelativehypovolemichypovolemicshockshock--internalfluidinternalfluidshiftsfromintravasculartointerstitialspa
5、ce.shiftsfromintravasculartointerstitialspace.Bp=COBp=CO××SVRSVRpressure(%ofnormal)Cardiacoutputandarterial%oftotalbloodremovedSVR:systemicvascularresistanceSVR:systemicvascularresistanceDistributiveShockDistributiveShockoccursasaresultofinadequatevascularoccursasaresult
6、ofinadequatevasculartone.tone.neurogenicneurogenicshockshocksepticshocksepticshockanaphylacticshockanaphylacticshocknormalHypovolemicHypovolemicshockdecreasedbloodbloodvolumevolumeVasogenicVasogenicshocknormalintravascularnormalcompartmentspaceintravascularcompartmentspa
7、cenormalbloodvolumeenlargedintravascularcompartmentspaceOutcomeofvesselenlargementCardiogenicCardiogenicShockShockoccurswhentheheartisunabletooccurswhentheheartisunabletofunctionadequatelyresultinginfunctionadequatelyresultingininsufficientbloodflowtotissueandinsufficien
8、tbloodflowtotissueandorgans.organs.myocardialinfarctionmyocardialinfarctionobstructionofbloodflowobstru
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