Proposed Reclassification of Shock States with Special Reference to Distributive Defects

Abstract

Some years ago, for lack of better knowledge, most of us were tempted to classify shock on an etiologic basis. We referred to: (a) shock due to blood loss (hypovolemic shock); (b) cardiogenic shock (pump failure); (c) bacterial shock (bacteremia, endotoxin); (d) acute hypersensitivity reactions (anaphylactic shock); (e) neurogenic shock (barbiturate and narcotic overdose, transection of the spinal cord; (f) shock associated with obstruction to blood flow, e. g., pulmonary embolization; and (g) endocrine forms of shock (myxedema, pheochromocytoma, adrenocortical insufficiency, insulin excess).

This study was supported by USPHS Research Grants HE-00570 from the National Heart and Lung Institute, GM-16462 from the National Institute of General Medical Sciences, and HS-00238 from the National Center for Health Services and Development, HSMHA.