Abstract
Circulatory shock is the clinical syndrome corresponding to acute circulatory failure, and can arise from a number of disease processes. The key feature of all forms of circulatory shock is an inability for tissues and cells to get enough oxygen in relation to their oxygen needs, ultimately resulting in cell death. Circulatory shock thus represents a critical condition where rapid and effective treatment can make the difference between life and death. In this chapter, we will briefly review the definition and pathophysiological classification of shock, principles of monitoring in patients with shock, and general management strategies.
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References
Weil MH, Shubin H (1972) Proposed reclassification of shock states with special reference to distributive defects. In: Hinshaw L, Cox B (eds) The fundamental mechanisms of shock. Plenum Press, New York, pp 13–23
Shah MR, Hasselblad V, Stevenson LW et al (2005) Impact of the pulmonary artery catheter in critically ill patients: Meta-analysis of randomized clinical trials. JAMA 294:1664–1670
Salem R, Vallee F, Rusca M, Mebazaa A (2008) Hemodynamic monitoring by echocardiography in the ICU: the role of the new echo techniques. Curr Opin Crit Care 14:561–568
Dark PM, Singer M (2004) The validity of trans-esophageal Doppler ultrasonography as a measure of cardiac output in critically ill adults. Intensive Care Med 30:2060–2066
Hofer CK, Zollinger A (2006) Less invasive cardiac output monitoring: Characteristics and limitations. In: Vincent JL (ed) Yearbook of intensive care and emergency medicine. Springer, Heidelberg, pp 162–175
Rivers E, Nguyen B, Havstad S et al (2001) Early goal-directed therapy in the treatment of severe sepsis and septic shock. N Engl J Med 345:1368–1377
Ladakis C, Myrianthefs P, Karabinis A et al (2001) Central venous and mixed venous oxygen saturation in critically ill patients. Respiration 68:279–285
Dueck MH, Klimek M, Appenrodt S et al (2005) Trends but not individual values of central venous oxygen saturation agree with mixed venous oxygen saturation during varying hemodynamic conditions. Anesthesiology 103:249–257
Binanay C, Califf RM, Hasselblad V et al (2005) Evaluation study of congestive heart failure and pulmonary artery catheterization effectiveness: the ESCAPE trial. JAMA 294:1625–1633
Harvey S, Young D, Brampton W et al (2006) Pulmonary artery catheters for adult patients in intensive care. Cochrane Database Syst Rev 3:CD003408
Vincent JL, Pinsky MR, Sprung CL et al (2008) The pulmonary artery catheter: in medio virtus. Crit Care Med 36:3093–3096
De Backer D, Creteur J, Dubois MJ et al (2006) The effects of dobutamine on microcirculatory alterations in patients with septic shock are independent of its systemic effects. Crit Care Med 34:403–408
Gomersall CD, Joynt GM, Freebairn RC et al (2000) Resuscitation of critically ill patients based on the results of gastric tonometry: a prospective, randomized, controlled trial. Crit Care Med 28:607–614
De Backer D, Hollenberg S, Boerma C et al (2007) How to evaluate the microcirculation: Report of a round table conference. Crit Care 11:R101
De Backer D, Creteur J, Dubois MJ et al (2004) Microvascular alterations in patients with acute severe heart failure and cardiogenic shock. Am Heart J 147:91–99
Sakr Y, Dubois MJ, De Backer D et al (2004) Persistent microcirculatory alterations are associated with organ failure and death in patients with septic shock. Crit Care Med 32:1825–1831
Sakr Y, Chierego M, Piagnerelli M et al (2007) Microvascular response to red blood cell transfusion in patients with severe sepsis. Crit Care Med 35:1639–1644
Buchele GL, Silva E, Ospina-Tascon GA et al (2009) Effects of hydrocortisone on microcirculatory alterations in patients with septic shock. Crit Care Med 37:1341–1347
De Backer D, Verdant C, Chierego M et al (2006) Effects of drotrecogin alfa activated on microcirculatory alterations in patients with severe sepsis. Crit Care Med 34:1918–1924
Weil MH, Shubin H (1969) The “VIP” approach to the bedside management of shock. JAMA 207:337–340
Vincent JL, Weil MH (2006) Fluid challenge revisited. Crit Care Med 34:1333–1337
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Vincent, J.L. (2009). Definition, Monitoring, and Management of Shock States. In: Gullo, A., Lumb, P.D., Besso, J., Williams, G.F. (eds) Intensive and Critical Care Medicine. Springer, Milano. https://doi.org/10.1007/978-88-470-1436-7_13
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DOI: https://doi.org/10.1007/978-88-470-1436-7_13
Publisher Name: Springer, Milano
Print ISBN: 978-88-470-1435-0
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