• Carla Braxton
  • J. Martin Perez


Shock, by definition, is a clinical syndrome that develops due to inadequate tissue perfusion. Hypoperfusion results in insufficient delivery of oxygen and nutrients for metabolism, leading to severe vital organ dysfunction. Untreated or undertreated shock may result in multiple organ failure and death. Patients enter into the shock state due to hypovolemia, trauma, sepsis, cardiac dysfunction, or severe neurologic compromise. The physician’s role in patient management is to ensure adequate hemodynamic support first (airway, breathing, circulation), followed by an aggressive search for the etiology of shock. With few exceptions, the first inotrope, the first pressor, should be fluid.


Septic Shock Cardiogenic Shock Hemorrhagic Shock Pulmonary Artery Catheter Hypovolemic Shock 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

Selected Readings

  1. Abou Khalil B, Scalea T, et al. Hemodynamic responses to shock in young trauma patients: the need for invasive monitoring. Crit Care Med 1994; 22(4):633–639.PubMedGoogle Scholar
  2. Cobb J, Perren. Critical care: a system-oriented approach. In: Norton JA, Bollinger RR, Chang AE, et al, eds. Surgery: Basic Science and Clinical Evidence. New York: Springer-Verlag, 2001.Google Scholar
  3. Ivanov R, Allen J, et al. Pumonary artery catheterization: narrative and systematic critique of randomized controlled trials and recommendations for the future. New Horizons 1997;5(3):268–276.PubMedGoogle Scholar
  4. Leibovici L, Drucker M, et al. Septic shock in bacteremic patients: risk factors, features and prognosis. Scand J Infect Dis 1997;20:71–75.CrossRefGoogle Scholar
  5. Leibowitz A, Beilin Y. Pulmonary artery catheters and outcome in the perioperative period. New Horizons 1997;5(3):214–221.PubMedGoogle Scholar
  6. McMahon D, Schwab C, et al. Comorbidity and the elderly trauma patient. World J Surg 1996;20:1113–1120.PubMedCrossRefGoogle Scholar
  7. Nathens AB, Maier RV. Shock and resuscitation. In: Norton JA, Bollinger RR, Chang AE, et al, eds. Surgery: Basic Science and Clinical Evidence. New York: Springer-Verlag, 2001.Google Scholar
  8. Parker M, Peruzzi W. Pulmonary artery catheters in sepsis/septic shock. New Horizons 1997;5(3):228–232.PubMedGoogle Scholar
  9. Reviewers CIGA. Human albumin administration in critically ill patient: systematic review of randomized controlled trials. Br Med J 1998;317:235–240.Google Scholar
  10. Scalea T, Simon H, et al. Geriatric blunt multitrauma: improved survival with early invasive monitoring. J Trauma 1990;30(2):129–134.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, Inc. 2005

Authors and Affiliations

  • Carla Braxton
    • 1
  • J. Martin Perez
    • 2
  1. 1.Department of SurgeryUniversity of Kansas HospitalKansas CityUSA
  2. 2.Department of SurgeryUniversity of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical SchoolNew BrunswickUSA

Personalised recommendations