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Chapter: Clinical Cases in Anesthesia : Shock

What is the definition of shock?

Shock is the failure to meet tissue demand for oxygen.

What is the definition of shock?

 

Shock is the failure to meet tissue demand for oxygen. The notion that a certain blood pressure is equated with shock should be dispelled. Instead, signs and symptoms consistent with the failure to meet demand should be reviewed.




 

Decline in mental status, poor distal perfusion of the extremities, low urinary output, and lactic acidosis would be the most common manifestations of shock. One of these signs and symptoms without any of the others is rarely encountered in true shock. Some patients may expe-rience a greater than 25% reduction in blood pressure, with a mean pressures in the fifties, and show none of these signs and symptoms. They should be classified as having a significant reduction in blood pressure that requires expla-nation, but not shock.

 

No single measurement can confirm the diagnosis of shock. In most types of circulatory shock, the mixed venous hemoglobin oxygen saturation will be decreased, as a reflection of the increased oxygen extraction by peripheral tissues. In septic shock, however, oxygen utilization by cells is impaired and the mixed venous saturation will be inap-propriately high.

 

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Clinical Cases in Anesthesia : Shock : What is the definition of shock? |


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