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Shock

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Surgical Intensive Care Medicine

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Abstract

Shock is generally regarded as a syndrome precipitated by a systemic global tissue hypoperfusion that leads to widespread cellular dysoxia and vital organ dysfunction. The three physiologic stages of shock (compensated, microvascular injury, and decompensated) are best understood in terms of oxygen debt. The microcirculation is the vital organ of the cardiovascular system, and changes at this level can and should guide resuscitation in patients presenting with shock. The etiology of shock (hypovolemic, cardiogenic, obstructive, distributive, septic) certainly guides specific therapies, but metabolic endpoints representing the microcirculation and tissue perfusion remain the same. Despite the difficulties inherent in diagnosing these occult forms of shock, it is of utmost importance to identify these patients as early as possible.

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Author information

Authors and Affiliations

  1. Department of Emergency Medicine, University of Michigan Health System, 1500 East Medical Center Drive, B1-380 Taubman Center, SPC 5382, Ann Arbor, MI, 48109, USA

    Joshua M. Glazer MD

  2. Department of Emergency Medicine and Surgical Critical Care, Henry Ford Hospital, Wayne State University, Detroit, Michigan, USA

    Emanuel P. Rivers MD, MPH

  3. Department of Emergency Medicine, Division of Emergency Critical Care, University of Michigan Health System, 1500 East Medical Center Drive, B1-354N Taubman Center, SPC 5303, Ann Arbor, MI, 48109, USA

    Kyle J. Gunnerson MD

Authors
  1. Joshua M. Glazer MD
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  2. Emanuel P. Rivers MD, MPH
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  3. Kyle J. Gunnerson MD
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Corresponding author

Correspondence to Kyle J. Gunnerson MD .

Editor information

Editors and Affiliations

  1. Department of Surgical Critical Care; Lahey Hospital and Medical Center, Division of Surgery, Burlington, Massachusetts, USA

    John M. O'Donnell

  2. Surgical Critical Care Medicine, Pr�-Card�o Hospital, Critical Care Medicine, University Hospital, Federal University of Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil

    Flávio E. Nácul

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Glazer, J.M., Rivers, E.P., Gunnerson, K.J. (2016). Shock. In: O'Donnell, J., Nácul, F. (eds) Surgical Intensive Care Medicine. Springer, Cham. https://doi.org/10.1007/978-3-319-19668-8_6

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  • DOI: https://doi.org/10.1007/978-3-319-19668-8_6

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