350:. Rupture of a hollow organ, with subsequent evacuation of contents in the peritoneal cavity could also determine neurogenic shock, a subtype of distributive shock. This happens due to the widespread peritoneal irritation by the ruptured viscus contents, as in peptic ulcer perforation, with consequent strong vagal activation, and generalized, extensive peripheral vasodilation and bradycardia. Thus, in neurogenic shock, there is decreased systemic vascular resistance, CVP is typically decreased, CO decreased or normal, and PAOP decreased.
424:. Hydrocortisone is used for people whose hypotension does not respond to fluid resuscitation and vasopressors. Opening and keeping open the microcirculation is a consideration in the treatment of distributive shock, as a result limiting the use of vasopressors has been suggested. Control of inflammation, vascular function and coagulation to correct pathological differences in blood flow and microvascular shunting has been pointed to as a potentially important adjunct goal in the treatment of distributive shock.
370:
502:
fluids. Drugs such as pyridoxalated hemoglobin polyoxyethylene, which scavenge nitric oxide from the blood, have been investigated, as well as methylene blue which may inhibit the nitric oxide-cyclic guanosine monophosphate (NO-cGMP) pathway which has been suggested to play a significant role in
194:. Causes of adrenal insufficiency leading to distributive shock include acute worsening of chronic adrenal insufficiency, destruction or removal of the adrenal glands, suppression of adrenal gland function due to exogenous steroids, hypopituitarism and metabolic failure of hormone production.
957:
Kinasewitz, Gary T.; Privalle, Christopher T.; Imm, Amy; Steingrub, Jay S.; et al. (July 2008). "Multicenter, randomized, placebo-controlled study of the nitric oxide scavenger pyridoxalated hemoglobin polyoxyethylene in distributive shock".
766:
De-Giorgio F, Lodise M, Pascali VL, Spagnolo AG, d'Aloja E, Arena V (2015). "An
Unusual Case Showing Fatal Rupture of a Gastric Ulcer or Gastromalacia? The Importance/Role of Histology for Differential Diagnosis".
724:
Weaver, Lynne C.; Fleming, Jennifer C.; Mathias, Christopher J.; Krassioukov, Andrie V. (2012). "Ch. 13: Disordered
Cardiovascular Control After Spinal Cord Injury". In Verhaagen, Joost; McDonald, John W. (eds.).
910:"Association of Vasopressin Plus Catecholamine Vasopressors vs Catecholamines Alone With Atrial Fibrillation in Patients With Distributive Shock: A Systematic Review and Meta-analysis"
1929:
1843:
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1922:
70:
which make up the body's tissues and organs. Distributive shock is different from the other three categories of shock in that it occurs even though the
1915:
1234:
810:
908:
McIntyre, WF; Um, KJ; Alhazzani, W; Lengyel, AP; Hajjar, L; Gordon, AC; Lamontagne, F; Healey, JS; Whitlock, RP; Belley-Côté, EP (8 May 2018).
1512:
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Civetta, Taylor, & Kirby's
Critical Care, 4th Edition. Chapter 59 Neurogenic Shock. Lippincott Williams & Wilkins 2009
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Elbers and Ince have identified five classes of abnormal microcirculatory flow in distributive shock using side stream
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Kanaparthi, Lalit K.; Klaus-Dieter, Lessnau; Peralta, Ruben (12 February 2013), Pinsky, Michael R. (ed.),
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drugs to treat the causative infection. Some sources of infection require surgical intervention including
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380:
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573:"Mechanisms of critical illness--classifying microcirculatory flow abnormalities in distributive shock"
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Septic shock is associated with significant mortality and is the leading non-cardiac cause of death in
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an international consortium of experts, did not find adequate evidence to support the superiority of
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The main goals of treatment in distributive shock are to reverse the underlying cause and achieve
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2020:
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cells lining the blood vessels become less responsive to vasoconstrictive agents, lose their
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91:
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Class II: there are empty capillaries next to capillaries that have flowing red blood cells.
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206:(blood delivery to tissues) in distributive shock is a lack of normal responsiveness of
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320:(SVR) triggered primarily by a massive release of histamine by mast cells activated by
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have been implicated. Infection sites most likely to lead to septic shock are chest,
107:
Class IV: hyperdynamic flow in capillaries adjacent to capillaries that are stagnant.
104:
Class III: there are stagnant capillaries next to capillaries with normal blood flow.
98:
Class I: all capillaries are stagnant when there is normal or sluggish venular flow.
989:
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1005:"Methylene blue for distributive shock: A potential new use of an old antidote"
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463:
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249:. In septic shock the blood flow in the microvasculature is abnormal with some
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2008:
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The choice of fluids for resuscitation remains an area of research, the
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Insufficient blood flow due to abnormal distribution in the capillaries
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121:: Decreased sympathetic stimulation leading to decreased vessel tone.
110:
Class V: widespread hyperdynamic flow in the microcirculatory system.
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536:
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729:. Handbook of Clinical Neurology. Vol. 109. pp. 213–33.
1891:
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466:
rather than norepinephrine alone appears to decrease the risk of
440:
321:
242:
114:
According to the cause, there are 4 types of distributive shock:
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1963:
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723:
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increases, inhibiting their flow through the microvasculature.
234:
159:
75:
59:
956:
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2090:
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that initiates the clotting cascade is produced by activated
253:
underperfused and others with normal to high blood flow. The
230:
221:
There are four types of distributive shock. The most common,
187:
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265:
charge, become leaky and cause extensive over-expression of
2528:
1766:
1452:
146:
In addition to sepsis, distributive shock can be caused by
1844:
European
Society of Paediatric and Neonatal Intensive Care
1003:
Jang, D.H.; Nelson, L.S.; Hoffman, R.S. (September 2013).
907:
281:
and the endothelial cells lining the blood vessels while
262:
1062:
74:
is at or above a normal level. The most common cause is
346:
due to injury to the central nervous system especially
1475:
Critical illness–related corticosteroid insufficiency
46:
results in inadequate supply of blood to the body's
526:
1002:
895:
883:
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632:
570:
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328:and also by increased production and release of
225:, is caused by an infection, most frequently by
950:
886:, Treatment: Surgical Control of Shock Sources.
78:leading to a type of distributive shock called
513:
1923:
1228:
1078:
673:"The microcirculation is the motor of sepsis"
571:Elbers, Paul W.G.; Ince, Can (19 July 2006).
566:
564:
562:
560:
558:
556:
554:
552:
809:: CS1 maint: multiple names: authors list (
408:stabilization. Immediate treatment involves
301:response. The ability of red blood cells to
38:condition in which abnormal distribution of
1242:
666:
664:
316:low blood pressure is related to decreased
1930:
1916:
1235:
1221:
1085:
1071:
717:
549:
528:"Distributive Shock: Overview: Background"
427:People with septic shock are treated with
357:results from inadequate steroid hormones.
1030:
996:
933:
700:
690:
600:
590:
661:
58:, a condition where there is not enough
148:systemic inflammatory response syndrome
2583:
898:, Treatment: Treatment of Anaphylaxis.
485:
291:Disseminated intravascular coagulation
170:(a sudden, severe allergic reaction),
1911:
1216:
1066:
874:, Treatment: Antimicrobial Treatment.
835:, Treatment: Approach Considerations.
1723:Recombinant activated protein C
670:
364:
150:(SIRS) due to conditions other than
1436:Multiple organ dysfunction syndrome
1421:Acute respiratory distress syndrome
1361:Multiple organ dysfunction syndrome
454:Anaphylactic shock is treated with
353:Distributive shock associated with
13:
735:10.1016/B978-0-444-52137-8.00013-9
338:is caused by the loss of vascular
197:
190:) insufficiency and damage to the
54:. It is one of four categories of
14:
2602:
1834:Society of Critical Care Medicine
1531:Ventilator-associated lung injury
1051:
82:, a condition that can be fatal.
368:
305:decreases and their tendency to
1536:Ventilator-associated pneumonia
1469:Critical illness polyneuropathy
901:
202:The cause of inadequate tissue
1143:Abdominal compartment syndrome
817:
759:
261:(normal coating) and negative
1:
1315:Geriatric intensive-care unit
1298:Pediatric intensive care unit
1010:Journal of Medical Toxicology
862:, Treatment: Corticosteroids.
506:
470:but with few other benefits.
1718:Neuromuscular-blocking drugs
1661:Nutritional supplementation
1292:Neonatal intensive care unit
974:10.1097/CCM.0b013e31817bfe84
769:Journal of Forensic Sciences
671:Ince, Can (25 August 2005).
658:, Overview: Pathophysiology.
473:
399:
360:
318:systemic vascular resistance
62:-carrying blood to meet the
7:
2558:superior vena cava syndrome
1818:Water-electrolyte imbalance
1652:Early goal-directed therapy
850:, Treatment: Resuscitation.
273:cascade is also disrupted.
10:
2607:
1670:Total parenteral nutrition
1603:Life-supporting treatments
1310:Critical illness insurance
344:sympathetic nervous system
342:normally supported by the
293:(DIC) can result from the
2527:
2471:radial artery sufficiency
2427:
2418:
2366:
2333:
2294:
2251:
2242:
2203:
2156:
2106:
1979:
1949:
1852:
1839:Surviving Sepsis Campaign
1826:
1790:
1747:
1685:
1635:Ventricular assist device
1630:Intra-aortic balloon pump
1601:
1581:Pulmonary artery catheter
1553:
1503:
1461:
1330:
1323:
1278:
1250:
1179:
1151:
1133:
1100:
1092:
1058:Surviving Sepsis Campaign
1023:10.1007/s13181-013-0298-7
492:Surviving Sepsis Campaign
141:
24:
2081:Pericardial friction rub
85:
2517:Nicoladoni–Branham sign
2181:Jugular venous pressure
2043:Pulmonary insufficiency
1733:Stress ulcer prevention
1677:Therapeutic hypothermia
1576:Central venous catheter
1244:Intensive care medicine
781:10.1111/1556-4029.12665
162:. Other causes include
2406:Gallavardin phenomenon
2244:Cardiovascular disease
1808:Level of consciousness
1615:mechanical ventilation
1513:Methicillin-resistant
961:Critical Care Medicine
926:10.1001/jama.2018.4528
896:Kanaparthi et al. 2013
884:Kanaparthi et al. 2013
872:Kanaparthi et al. 2013
860:Kanaparthi et al. 2013
848:Kanaparthi et al. 2013
833:Kanaparthi et al. 2013
656:Kanaparthi et al. 2013
633:Kanaparthi et al. 2013
377:This section is empty.
192:central nervous system
44:smallest blood vessels
2511:arteriovenous fistula
2325:Bracht–Wachter bodies
1515:Staphylococcus aureus
635:, Overview: Etiology.
433:necrotizing fasciitis
172:adrenal insufficiency
92:dark field microscopy
2348:Pericardial effusion
2253:Aortic insufficiency
2066:Mitral insufficiency
2048:Graham Steell murmur
1490:Stress hyperglycemia
1331:Organ system failure
1265:Medical specialities
1125:Toxic shock syndrome
503:distributive shock.
480:intensive care units
186:poisoning, hepatic (
164:toxic shock syndrome
2591:Medical emergencies
2281:Austin Flint murmur
2060:Carey Coombs murmur
1853:Related specialties
1813:Acid–base imbalance
1749:ICU scoring systems
1620:Tracheal intubation
1431:Respiratory failure
1426:Acute liver failure
1416:Acute renal failure
1286:Intensive care unit
1270:Respiratory therapy
486:Research directions
468:atrial fibrillation
445:intestinal ischemia
410:fluid resuscitation
247:genitourinary tract
72:output of the heart
2552:Trendelenburg test
2485:pseudohypertension
2463:Right heart strain
2457:pulmonary embolism
2072:Presystolic murmur
1943:circulatory system
1939:Signs and symptoms
1762:Glasgow Coma Scale
1713:Intravenous fluids
1593:Screening cultures
1561:Arterial blood gas
1526:Refeeding syndrome
1443:Neonatal infection
1404:Vasodilatory shock
1379:Distributive shock
1304:Coronary care unit
1202:Vasodilatory shock
1120:Anaphylactic shock
727:Spinal Cord Injury
533:Medscape Reference
348:spinal cord injury
314:anaphylactic shock
214:agents and direct
125:Anaphylactic shock
32:Distributive shock
25:Distributive shock
2578:
2577:
2574:
2573:
2537:Friedreich's sign
2444:Cardarelli's sign
2414:
2413:
2344:Cardiac tamponade
2136:Pulsus bisferiens
2026:Functional murmur
1905:
1904:
1865:Internal medicine
1611:Airway management
1549:
1548:
1389:Obstructive shock
1374:Cardiogenic shock
1210:
1209:
920:(18): 1889–1900.
685:(Supp 4): S13-9.
397:
396:
29:
28:
19:Medical condition
2598:
2564:Pemberton's sign
2425:
2424:
2420:Vascular disease
2266:De Musset's sign
2261:Collapsing pulse
2249:
2248:
2148:Pulsus alternans
2141:Pulsus bigeminus
2126:Pulsus paradoxus
1941:relating to the
1932:
1925:
1918:
1909:
1908:
1626:Cardiac devices
1480:Decubitus ulcers
1394:Neurogenic shock
1328:
1327:
1237:
1230:
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1214:
1213:
1115:Neurogenic shock
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1080:
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994:
993:
968:(7): 1999–2007.
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392:
389:
379:You can help by
372:
365:
336:Neurogenic shock
326:immunoglobulin E
297:produced in the
212:vasoconstrictive
119:Neurogenic shock
22:
21:
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2605:
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2599:
2597:
2596:
2595:
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2579:
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2547:Kussmaul's sign
2523:
2438:aortic aneurysm
2410:
2382:Anitschkow cell
2375:rheumatic fever
2362:
2329:
2290:
2271:Duroziez's sign
2238:
2199:
2152:
2102:
1975:
1945:
1936:
1906:
1901:
1848:
1822:
1786:
1743:
1703:Antithrombotics
1681:
1665:Enteral feeding
1647:Kidney dialysis
1597:
1545:
1521:Oxygen toxicity
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449:medical devices
412:and the use of
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198:Pathophysiology
174:, reactions to
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2234:Template:Shock
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2031:Still's murmur
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1860:Anesthesiology
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1757:APACHE II
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1588:Blood cultures
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1487:
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1477:
1472:
1465:
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1407:
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1396:
1391:
1386:
1381:
1376:
1371:
1364:
1363:
1358:
1353:
1348:
1343:
1338:
1337:Shock sequence
1334:
1332:
1325:
1321:
1320:
1318:
1317:
1312:
1307:
1301:
1295:
1289:
1282:
1280:
1276:
1275:
1273:
1272:
1267:
1262:
1257:
1255:Health science
1251:
1248:
1247:
1240:
1239:
1232:
1225:
1217:
1208:
1207:
1205:
1204:
1199:
1194:
1189:
1183:
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1177:
1176:
1174:
1173:
1172:
1171:
1161:
1155:
1153:
1149:
1148:
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1145:
1139:
1137:
1131:
1130:
1128:
1127:
1122:
1117:
1112:
1106:
1104:
1098:
1097:
1090:
1089:
1082:
1075:
1067:
1061:
1060:
1053:
1052:External links
1050:
1047:
1046:
995:
949:
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888:
876:
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837:
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758:
743:
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692:10.1186/cc3753
660:
637:
616:
592:10.1186/cc4969
548:
511:
510:
508:
505:
498:fluids versus
487:
484:
475:
472:
464:norepinephrine
462:together with
447:, or infected
401:
398:
395:
394:
375:
373:
362:
359:
355:adrenal crisis
330:prostaglandins
307:clump together
289:are impaired.
199:
196:
143:
140:
139:
138:
136:adrenal crisis
132:
127:
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112:
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87:
84:
27:
26:
18:
15:
9:
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2603:
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2565:
2562:
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2555:
2553:
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2548:
2545:
2543:
2542:Caput medusae
2540:
2538:
2535:
2534:
2532:
2530:
2526:
2518:
2515:
2514:
2513:
2512:
2508:
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2503:
2499:
2498:Lines of Zahn
2496:
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2493:
2489:
2487:
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2478:
2475:
2474:
2473:
2472:
2468:
2464:
2461:
2460:
2459:
2458:
2454:
2450:
2449:Oliver's sign
2447:
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2440:
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2423:
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2307:
2303:
2302:
2300:
2298:
2293:
2287:
2284:
2282:
2279:
2277:
2276:MĂĽller's sign
2274:
2272:
2269:
2267:
2264:
2262:
2259:
2258:
2256:
2254:
2250:
2247:
2245:
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2231:
2229:
2226:
2224:
2221:
2219:
2216:
2214:
2211:
2210:
2208:
2206:
2202:
2196:
2194:
2191:
2187:
2184:
2183:
2182:
2179:
2177:
2176:CĹ“ur en sabot
2174:
2170:
2167:
2166:
2165:
2162:
2161:
2159:
2155:
2149:
2146:
2142:
2139:
2137:
2134:
2133:
2132:
2129:
2127:
2124:
2122:
2119:
2117:
2114:
2113:
2111:
2109:
2105:
2097:
2094:
2093:
2092:
2089:
2087:
2084:
2082:
2079:
2073:
2070:
2069:
2068:
2067:
2063:
2061:
2058:
2056:
2053:
2049:
2046:
2044:
2041:
2040:
2039:
2036:
2032:
2029:
2027:
2024:
2023:
2022:
2019:
2018:
2017:
2014:
2010:
2009:Gallop rhythm
2007:
2005:
2002:
2000:
1997:
1995:
1992:
1991:
1990:
1987:
1986:
1984:
1982:
1978:
1970:
1969:Levine's sign
1967:
1966:
1965:
1962:
1960:
1959:Referred pain
1957:
1956:
1954:
1952:
1948:
1944:
1940:
1933:
1928:
1926:
1921:
1919:
1914:
1913:
1910:
1898:
1895:
1893:
1890:
1888:
1885:
1881:
1878:
1876:
1873:
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1868:
1867:
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1861:
1858:
1857:
1855:
1851:
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1840:
1837:
1835:
1832:
1831:
1829:
1827:Organisations
1825:
1819:
1816:
1814:
1811:
1809:
1806:
1804:
1801:
1799:
1796:
1795:
1793:
1789:
1783:
1780:
1778:
1777:SAPS III
1775:
1773:
1770:
1768:
1765:
1763:
1760:
1758:
1755:
1754:
1752:
1750:
1746:
1740:
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1640:
1636:
1633:
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1628:
1627:
1625:
1621:
1618:
1617:
1616:
1612:
1609:
1608:
1606:
1604:
1600:
1594:
1591:
1589:
1586:
1582:
1579:
1577:
1574:
1572:
1571:Arterial line
1569:
1568:
1567:
1564:
1562:
1559:
1558:
1556:
1552:
1542:
1539:
1537:
1534:
1532:
1529:
1527:
1524:
1522:
1519:
1517:
1516:
1511:
1510:
1508:
1506:
1502:
1496:
1493:
1491:
1488:
1486:
1483:
1481:
1478:
1476:
1473:
1470:
1467:
1466:
1464:
1462:Complications
1460:
1454:
1451:
1449:
1446:
1444:
1441:
1440:
1437:
1434:
1432:
1429:
1427:
1424:
1422:
1419:
1417:
1414:
1412:
1411:Organ failure
1409:
1408:
1405:
1402:
1400:
1397:
1395:
1392:
1390:
1387:
1385:
1382:
1380:
1377:
1375:
1372:
1370:
1366:
1365:
1362:
1359:
1357:
1354:
1352:
1351:Severe sepsis
1349:
1347:
1344:
1342:
1339:
1336:
1335:
1333:
1329:
1326:
1322:
1316:
1313:
1311:
1308:
1305:
1302:
1299:
1296:
1293:
1290:
1287:
1284:
1283:
1281:
1279:General terms
1277:
1271:
1268:
1266:
1263:
1261:
1258:
1256:
1253:
1252:
1249:
1245:
1238:
1233:
1231:
1226:
1224:
1219:
1218:
1215:
1203:
1200:
1198:
1197:Cryptic shock
1195:
1193:
1190:
1188:
1185:
1184:
1182:
1178:
1170:
1169:Osmotic shock
1167:
1166:
1165:
1162:
1160:
1157:
1156:
1154:
1150:
1144:
1141:
1140:
1138:
1136:
1132:
1126:
1123:
1121:
1118:
1116:
1113:
1111:
1108:
1107:
1105:
1103:
1099:
1095:
1088:
1083:
1081:
1076:
1074:
1069:
1068:
1065:
1059:
1056:
1055:
1042:
1038:
1033:
1028:
1024:
1020:
1016:
1012:
1011:
1006:
999:
991:
987:
983:
979:
975:
971:
967:
963:
962:
953:
945:
941:
936:
931:
927:
923:
919:
915:
911:
904:
897:
892:
885:
880:
873:
868:
861:
856:
849:
844:
842:
834:
829:
820:
812:
806:
798:
794:
790:
786:
782:
778:
774:
770:
762:
754:
750:
746:
744:9780444521378
740:
736:
732:
728:
720:
712:
708:
703:
698:
693:
688:
684:
680:
679:
678:Critical Care
674:
667:
665:
657:
652:
650:
648:
646:
644:
642:
634:
629:
627:
625:
623:
621:
612:
608:
603:
598:
593:
588:
584:
580:
579:
578:Critical Care
574:
567:
565:
563:
561:
559:
557:
555:
553:
538:
534:
529:
521:
519:
517:
512:
504:
501:
497:
493:
483:
481:
471:
469:
465:
461:
458:. The use of
457:
452:
450:
446:
442:
438:
434:
430:
429:antimicrobial
425:
423:
419:
415:
411:
407:
391:
388:February 2019
382:
378:
374:
371:
367:
366:
358:
356:
351:
349:
345:
341:
337:
333:
331:
327:
323:
319:
315:
310:
308:
304:
300:
296:
292:
288:
284:
280:
276:
275:Tissue factor
272:
268:
264:
260:
256:
252:
248:
244:
240:
236:
232:
228:
224:
219:
217:
213:
209:
208:blood vessels
205:
195:
193:
189:
185:
181:
177:
173:
169:
165:
161:
157:
153:
149:
137:
134:Shock due to
133:
131:
128:
126:
123:
120:
117:
116:
115:
109:
106:
103:
100:
97:
96:
95:
93:
83:
81:
77:
73:
69:
66:needs of the
65:
61:
57:
53:
49:
45:
41:
37:
33:
23:
2556:
2509:
2505:Adson's sign
2490:
2483:
2477:Allen's test
2469:
2455:
2436:
2391:
2387:Aschoff body
2373:
2358:Ewart's sign
2353:Beck's triad
2342:
2320:Osler's node
2306:endocarditis
2304:
2286:Mayne's sign
2232:See further
2228:Distributive
2227:
2164:Palpitations
2130:
2064:
2016:Heart murmur
1989:Heart sounds
1981:Auscultation
1897:Traumatology
1798:Hemodynamics
1772:SAPS II
1739:Vasopressors
1657:Induced coma
1514:
1505:Iatrogenesis
1495:Stress ulcer
1399:Spinal shock
1378:
1356:Septic shock
1192:Spinal shock
1110:Septic shock
1102:Distributive
1101:
1017:(3): 242–9.
1014:
1008:
998:
965:
959:
952:
917:
913:
903:
891:
879:
867:
855:
828:
819:
805:cite journal
775:(1): 240–2.
772:
768:
761:
726:
719:
682:
676:
582:
576:
540:, retrieved
532:
489:
477:
453:
426:
418:vasopressors
416:drugs, both
403:
385:
381:adding to it
376:
352:
334:
311:
303:change shape
299:inflammatory
287:fibrinolysis
283:antithrombin
267:nitric oxide
223:septic shock
220:
216:vasodilation
201:
156:pancreatitis
145:
130:Septic shock
113:
89:
80:septic shock
31:
30:
2335:Pericardium
2311:Roth's spot
2297:endocardium
2223:Hypovolemic
2218:Obstructive
2213:Cardiogenic
2121:Bradycardia
2116:Tachycardia
2086:Heart click
1880:Pulmonology
1803:Hypotension
1698:Antibiotics
1541:Dialytrauma
1384:Anaphylaxis
1187:Cardiogenic
1164:Hypovolemia
1135:Obstructive
496:crystalloid
460:vasopressin
456:epinephrine
437:cholangitis
406:hemodynamic
271:coagulation
255:endothelial
251:capillaries
184:heavy metal
168:anaphylaxis
158:, burns or
2193:Hyperaemia
2055:Continuous
1951:Chest pain
1887:Pediatrics
1870:Cardiology
1791:Physiology
1693:Analgesics
1642:Chest tube
1471:/ myopathy
1448:Polytrauma
1324:Conditions
1159:Hemorrhage
1152:Low-volume
585:(4): 221.
542:2014-04-28
507:References
414:vasoactive
259:glycocalyx
40:blood flow
2169:Apex beat
2038:Diastolic
1875:Neurology
1728:Sedatives
1708:Inotropes
1554:Diagnosis
474:Prognosis
422:inotropes
400:Treatment
361:Diagnosis
279:monocytes
239:parasites
204:perfusion
152:infection
64:metabolic
2585:Category
2492:thrombus
2429:Arterial
2021:Systolic
1994:Split S2
1566:Catheter
1485:Fungemia
1260:Medicine
1041:23580172
990:30123186
982:18552688
944:29801010
789:25388056
753:23098715
711:16168069
611:16879732
537:Medscape
482:(ICUs).
295:thrombin
227:bacteria
154:such as
2131:doubled
2096:carotid
1892:Surgery
1032:3770994
935:6583502
797:1458157
702:3226164
602:1750971
500:colloid
441:abscess
324:-bound
322:antigen
243:abdomen
231:viruses
166:(TSS),
48:tissues
42:in the
36:medical
2529:Venous
2399:J wave
2295:Other
1964:Angina
1367:Other
1346:Sepsis
1300:(PICU)
1294:(NICU)
1039:
1029:
988:
980:
942:
932:
795:
787:
751:
741:
709:
699:
609:
599:
269:. The
229:, but
180:toxins
160:trauma
142:Causes
76:sepsis
60:oxygen
52:organs
2367:Other
2205:Shock
2157:Other
2108:Pulse
2091:Bruit
1735:drugs
1686:Drugs
1369:shock
1306:(CCU)
1288:(ICU)
1180:Other
1094:Shock
986:S2CID
793:S2CID
263:ionic
235:fungi
188:liver
176:drugs
86:Types
68:cells
56:shock
34:is a
1782:SOFA
1767:PIM2
1613:and
1453:Coma
1341:SIRS
1037:PMID
978:PMID
940:PMID
914:JAMA
811:link
785:PMID
749:PMID
739:ISBN
707:PMID
607:PMID
420:and
340:tone
285:and
245:and
237:and
50:and
2393:EKG
1027:PMC
1019:doi
970:doi
930:PMC
922:doi
918:319
777:doi
731:doi
697:PMC
687:doi
597:PMC
587:doi
383:.
312:In
210:to
178:or
2587::
2004:S4
1999:S3
1035:.
1025:.
1013:.
1007:.
984:.
976:.
966:36
964:.
938:.
928:.
916:.
912:.
840:^
807:}}
803:{{
791:.
783:.
773:60
771:.
747:.
737:.
705:.
695:.
681:.
675:.
663:^
640:^
619:^
605:.
595:.
583:10
581:.
575:.
551:^
535:,
531:,
515:^
451:.
443:,
439:,
435:,
332:.
233:,
218:.
182:,
94:.
2377::
2350::
2346:/
2318:/
2308::
1931:e
1924:t
1917:v
1236:e
1229:t
1222:v
1086:e
1079:t
1072:v
1043:.
1021::
1015:9
992:.
972::
946:.
924::
813:)
799:.
779::
755:.
733::
713:.
689::
683:4
613:.
589::
545:.
390:)
386:(
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