39:
1975:) due to excessive nervous stimulation. Other competing theories around the turn of the century included one penned by Malcom in 1907, in which the assertion was that prolonged vasoconstriction led to the pathophysiological signs and symptoms of shock. In the following World War I, research concerning shock resulted in experiments by Walter B. Cannon of Harvard and William M. Bayliss of London in 1919 that showed that an increase in permeability of the capillaries in response to trauma or toxins was responsible for many clinical manifestations of shock. In 1972 Hinshaw and Cox suggested the classification system for shock which is still used today.
1089:
1916:
1326:
1764:
1928:, especially septic shock where treatment is delayed or the antimicrobial drugs are ineffective, however has a mortality rate between 30% and 80%; cardiogenic shock has a mortality rate of up to 70% to 90%, though quick treatment with vasopressors and inotropic drugs, cardiac surgery, and the use of assistive devices can lower the mortality.
1341:
loop. Poor blood supply leads to cellular damage, which results in an inflammatory response to increase blood flow to the affected area. Normally, this causes the blood supply level to match with tissue demand for nutrients. However, if there is enough increased demand in some areas, it can deprive
988:
Consensus
Conference Committee defined septic shock: " ... sepsis-induced hypotension (systolic blood pressure < 90 mmHg or a reduction of 40 mmHg from baseline) despite adequate fluid resuscitation along with the presence of perfusion abnormalities that may include, but are not
1353:
failure, where the usual corrective mechanisms relating to oxygenation of the body no longer function in a stable way. When it occurs, immediate treatment is critical in order to return an individual's metabolism into a stable, self-correcting trajectory. Otherwise the condition can become
1624:, and laboratory tests. Many signs and symptoms are not sensitive or specific for shock, thus many clinical decision-making tools have been developed to identify shock at an early stage. A high degree of suspicion is necessary for the proper diagnosis of shock.
1793:
There is no evidence of substantial benefit of one vasopressor over another; however, using dopamine leads to an increased risk of arrhythmia when compared with norepinephrine. Vasopressors have not been found to improve outcomes when used for
3911:
1333:
There are four stages of shock. Shock is a complex and continuous condition, and there is no sudden transition from one stage to the next. At a cellular level, shock is the process of oxygen demand becoming greater than oxygen supply.
395:
may be useful in certain cases. Shock is both common and has a high risk of death. In the United States about 1.2 million people present to the emergency room each year with shock and their risk of death is between 20 and 50%.
3950:
1719:
appear to be equally effective with respect to outcomes., Balanced crystalloids and normal saline also appear to be equally effective in critically ill patients. If the person remains in shock after initial resuscitation,
1515:
The
Progressive stage (stage 3) results if the underlying cause of the shock is not successfully treated. During this stage, compensatory mechanisms begin to fail. Due to the decreased perfusion of the cells in the body,
612:(heart rate divided by systolic blood pressure) is a stronger predictor of the impact of blood loss than heart rate and blood pressure alone. This relationship has not been well established in pregnancy-related bleeding.
1406:
The
Compensatory stage (Stage 2) is characterised by the body employing physiological mechanisms, including neural, hormonal, and bio-chemical mechanisms, in an attempt to reverse the condition. As a result of the
1317:. It can be divided into four main types based on the underlying cause: hypovolemic, distributive, cardiogenic, and obstructive. A few additional classifications are occasionally used, such as endocrinologic shock.
1220:
treatment without tapering the dosage. However, surgery and intercurrent disease in patients on corticosteroid therapy without adjusting the dosage to accommodate for increased requirements may also result in this
3330:
Wu MC, Liao TY, Lee EM, Chen YS, Hsu WT, Lee MG, Tsou PY, Chen SC, Lee CC (November 2017). "Administration of
Hypertonic Solutions for Hemorrhagic Shock: A Systematic Review and Meta-analysis of Clinical Trials".
4124:
4109:
1923:
The prognosis of shock depends on the underlying cause and the nature and extent of concurrent problems. Low volume, anaphylactic, and neurogenic shock are readily treatable and respond well to medical therapy.
2581:
Cheatham, Michael L.; Malbrain, Manu L. N. G.; Kirkpatrick, Andrew; Sugrue, Michael; Parr, Michael; De Waele, Jan; Balogh, Zsolt; Leppäniemi, Ari; Olvera, Claudia; Ivatury, Rao; D'Amours, Scott (June 2007).
1814:, has been found not to improve survival and is associated with a number of complications. Activated protein C was withdrawn from the market in 2011, and clinical trials were discontinued. The use of
38:
1952:.) In this text he describes "choc" as a reaction to the sudden impact of a missile. However, the first English writer to use the word shock in its modern-day connotation was James Latta, in 1795.
1892:
of 65–95 mmHg. In trauma the goal is to stop the bleeding which in many cases requires surgical interventions. A good urine output indicates that the kidneys are getting enough blood flow.
1663:
in adults. However, the pathophysiology of shock in children appears to be similar so treatment methodologies have been extrapolated to children. Management may include securing the airway via
1354:
increasingly difficult to correct, surprisingly quickly, and then progress to a fatal outcome. In the particular case of anaphylactic shock, progression to death might take just a few minutes.
416:, those who are athletic, and in 30% of cases of those with shock due to intra abdominal bleeding, heart rate may be normal or slow. Specific subtypes of shock may have additional symptoms.
5075:
997:
or vasopressor agents may have a normalized blood pressure at the time that perfusion abnormalities are identified. The pathophysiology behind septic shock is as follows: 1) Systemic
3050:
Mbaruku, Godfrey; Therrien, Michelle Skaer; Tillya, Robert; Mbuyita, Selemani; Mtema, Zacharia; Kinyonge, Iddajovana; Godfrey, Ritha; Temu, Silas; Miller, Suellen (December 2018).
1608:. Because cells can only produce adenosine at a rate of about 2% of the cell's total need per hour, even restoring oxygen is futile at this point because there is no adenosine to
1027:
criteria. The most generally accepted treatment for these patients is early recognition of symptoms, and early administration of broad spectrum and organism specific antibiotics.
1903:(a form of distributive shock), is the most common form of shock. Shock from blood loss occurs in about 1–2% of trauma cases. Overall, up to one-third of people admitted to the
798:
and severe abdominal trauma. This increased pressure reduces blood flow back to the heart, thereby reducing blood flow to the body and resulting in signs and symptoms of shock.
1699:
as well as adequately manage pain and anxiety as these can increase oxygen consumption. Negative impact by shock is reversible if it's recognized and treated early in time.
404:
The presentation of shock is variable, with some people having only minimal symptoms such as confusion and weakness. While the general signs for all types of shock are
4989:
4620:
3226:"Balanced crystalloids versus normal saline for fluid resuscitation in critically ill patients: A systematic review and meta-analysis with trial sequential analysis"
2765:
1857:(IABP) – a device inserted into the aorta that mechanically raises the blood pressure. Use of Intra-aortic balloon pumps is not recommended in cardiogenic shock.
2155:
Olaussen A, Blackburn T, Mitra B, Fitzgerald M (June 2014). "Review article: shock index for prediction of critical bleeding post-trauma: a systematic review".
1588:
and cell death are occurring, and death will occur imminently. One of the primary reasons that shock is irreversible at this point is that much of the cellular
5068:
3296:
2974:"Sensitivity and Specificity of SIRS, qSOFA and Severe Sepsis for Mortality of Patients Presenting to the Emergency Department With Suspected Infection"
1907:(ICU) are in circulatory shock. Of these, cardiogenic shock accounts for approximately 20%, hypovolemic about 20%, and septic shock about 60% of cases.
1731:
For those with hemorrhagic shock, the current evidence supports limiting the use of fluids for penetrating thorax and abdominal injuries allowing mild
5061:
4380:
3727:
Cecconi M, De Backer D, Antonelli M, Beale R, Bakker J, Hofer C, Jaeschke R, Mebazaa A, Pinsky MR, Teboul JL, Vincent JL, Rhodes A (December 2014).
1647:
as the result. While many laboratory tests are typically performed, there is no test that either conclusively makes or excludes the diagnosis. A
1695:) can be used to prevent further blood loss and concentrate fluid in the body's head and core. It is important to keep the person warm to avoid
1863:(VAD) – A mechanical pump that helps pump blood throughout the body. Commonly used in short term cases of refractory primary cardiogenic shock.
2904:
2584:"Results from the International Conference of Experts on Intra-abdominal Hypertension and Abdominal Compartment Syndrome. II. Recommendations"
1560:
increase, causing sludging of the micro-circulation. The prolonged vasoconstriction will also cause the vital organs to be compromised due to
964:
on their surface that produces adverse biochemical, immunological and occasionally neurological effects which are harmful to the body), other
4026:
4022:
1818:
is controversial as it has not been shown to improve outcomes. If used at all it should only be considered if the blood pH is less than 7.0.
3993:
1948:'s 1740 text, Traité ou Reflexions Tire'es de la Pratique sur les Playes d'armes à feu (A treatise, or reflections, drawn from practice on
802:
Many of the signs of obstructive shock are similar to cardiogenic shock, however treatments differ. Symptoms of obstructive shock include:
794:
defined as an increase in intra-abdominal pressure to > 20 mmHg with organ dysfunction. Increased intraabdominal pressure can be due to
4658:
3958:
1172:
Although not officially classified as a subcategory of shock, many endocrinology disturbances in their severe form can result in shock.
3013:"Temporal physiologic patterns of shock and circulatory dysfunction based on early descriptions by invasive and noninvasive monitoring"
3052:"Implementation project of the non-pneumatic anti-shock garment and m-communication to enhance maternal health care in rural Tanzania"
1944:
to signify a state of being "drained of blood". Shock or "choc" was first described in a trauma victim in the
English translation of
3374:
Gamper, Gunnar; Havel, Christof; Arrich, Jasmin; Losert, Heidrun; Pace, Nathan Leon; MĂĽllner, Marcus; Herkner, Harald (2016-02-15).
629:
is caused by the failure of the heart to pump effectively. This can be due to damage to the heart muscle, most often from a large
4486:
1024:
841:
2205:
Guyton, Arthur; Hall, John (2006). "Chapter 24: Circulatory Shock and
Physiology of Its Treatment". In Gruliow, Rebecca (ed.).
1010:
4373:
4230:
3790:
3274:
3159:
2937:
2741:
2396:
2288:
2260:
2214:
2805:
Cocchi MN, Kimlin E, Walsh M, Donnino MW (August 2007). "Identification and resuscitation of the trauma patient in shock".
2640:
2076:
2027:
981:
3729:"Consensus on circulatory shock and hemodynamic monitoring. Task force of the European Society of Intensive Care Medicine"
4581:
4566:
4506:
1872:
1711:
bolus over 10 minutes or 20 mL/kg in a child) which is usually instituted as the person is being further evaluated.
2776:
2647:) (June 1992). "Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis".
1936:
There is no evidence of the word shock being used in its modern-day form prior to 1743. However, there is evidence that
3780:
2113:
1631:, Unfortunately the measurement of cardiac output requires an invasive catheter, such as a pulmonary artery catheter.
3811:
1503:
production. However the effects of the renin–angiotensin axis take time and are of little importance to the immediate
4979:
4676:
4050:
2693:
2644:
985:
3578:
Boyd JH, Walley KR (August 2008). "Is there a role for sodium bicarbonate in treating lactic acidosis from shock?".
5736:
4366:
1688:
1636:
781:
3316:
1342:
other areas of sufficient supply, which then start demanding more. This then leads to an ever escalating cascade.
4822:
4681:
4614:
1639:(ScvO2) as measured via a central line correlates well with SmvO2 and is easier to acquire. If shock progresses
936:
is the most common cause of distributive shock. It is caused by an overwhelming systemic infection resulting in
4953:
4288:
1632:
1127:
1050:
791:
1023:
which causes intense dilation of the blood vessels. People with septic shock will also likely be positive for
4460:
4443:
4004:(8). Medical Research Committee, Special Investigation Committee on Surgical Shock and Allied Conditions: 19.
3056:
2527:
856:
5741:
5498:
4437:
3151:
1692:
1472:
49:
2365:
5703:
5662:
4863:
4797:
1775:
5053:
2852:"Mechanisms of critical illness – classifying microcirculatory flow abnormalities in distributive shock"
348:) or a fast heart rate raises concerns. The heart rate divided by systolic blood pressure, known as the
4455:
4400:
3480:
Diez C, Varon AJ (December 2009). "Airway management and initial resuscitation of the trauma patient".
1774:
may be used if blood pressure does not improve with fluids. Common vasopressors used in shock include:
1152:
578:
2973:
5470:
4984:
4780:
4775:
4726:
4223:
3886:
1860:
1854:
1600:. Adenosine easily perfuses out of cellular membranes into extracellular fluid, furthering capillary
1424:
785:
776:
746:
101:
2819:
2333:
1945:
1439:
resulting from large amounts of blood being redirected to distant tissues, and cause the release of
468:
are more common causes in children. Other causes include burns, as well as excess urine loss due to
5746:
5226:
4139:
3621:
Vincent, Jean-Louis; De Backer, Daniel (2013-10-31). Finfer, Simon R.; Vincent, Jean-Louis (eds.).
1822:
1676:
1375:
1371:
1002:
646:
345:
5326:
5188:
4878:
4721:
4706:
4389:
3876:
3528:"Human recombinant protein C for severe sepsis and septic shock in adult and paediatric patients"
1885:
1744:
673:
341:
5551:
5389:
5183:
4958:
4760:
3985:
3946:
3224:
Liu, C; Lu, G; Wang, D; Lei, Y; Mao, Z; Hu, P; Hu, J; Liu, R; Han, D; Zhou, F (November 2019).
2814:
1889:
1740:
1736:
1721:
1680:
1635:(SmvO2) is one of the methods of calculating cardiac output with a pulmonary artery catheter..
1589:
1532:
predominates. As anaerobic metabolism continues, the arteriolar smooth muscle and precapillary
1488:
1155:
and warm skin due to dilation of the peripheral blood vessels. (This term can be confused with
1147:, which is commonly classified as a subset of distributive shock. The classic symptoms include
1083:
890:
732:
of the systemic or pulmonary circulation. Several conditions can result in this form of shock.
654:
384:
66:
20:
4179:
759:
Through increased intrathoracic pressure, bloodflow to the heart is prevented (venous return).
412:, and confusion, these may not always be present. While a fast heart rate is common, those on
5656:
5166:
4963:
4884:
2100:
1529:
1391:
1225:
1209:
1135:
956:
630:
469:
428:
3827:
Bloch, Jack H.; Dietzman, Ronald H.; Pierce, Charles H.; Lillehei, Richard C. (April 1966).
3175:
Lewis SR, Pritchard MW, Evans DJ, Butler AR, Alderson P, Smith AF, Roberts I (August 2018).
2472:
1667:
if necessary to decrease the work of breathing and for guarding against respiratory arrest.
371:
should be established. Any ongoing bleeding should be stopped, which may require surgery or
5682:
5589:
5493:
5398:
5211:
5193:
4815:
4635:
4270:
4216:
3898:
2425:
1640:
1621:
1597:
1525:
1476:
756:
708:
650:
333:
310:
155:
608:
The severity of hemorrhagic shock can be graded on a 1–4 scale on the physical signs. The
8:
5709:
5538:
5426:
5411:
5205:
4858:
4765:
4686:
4576:
4571:
4561:
4431:
4415:
4128:
1904:
1807:
1672:
1106:
1006:
951:
896:
704:
634:
380:
53:
5421:
2429:
2412:
Pacagnella RC, Souza JP, Durocher J, Perel P, Blum J, Winikoff B, GĂĽlmezoglu AM (2013).
1479:(anti-diuretic hormone) is released to conserve fluid by reducing its excretion via the
5697:
5692:
5630:
5608:
5602:
5416:
5373:
5217:
5200:
5149:
5088:
5084:
4907:
4738:
4671:
4588:
4549:
4524:
4449:
4347:
4265:
4247:
4133:
4038:
4016:
3753:
3728:
3709:
3660:
3603:
3552:
3527:
3505:
3457:
3432:
3408:
3375:
3356:
3201:
3176:
3128:
3080:
3051:
2878:
2851:
2621:
2563:
2508:
2448:
2413:
2321:
2180:
1884:
The goal of treatment is to achieve a urine output of greater than 0.5 mL/kg/h, a
1815:
1752:
1314:
1294:
1229:
1213:
1059:
904:
882:
835:
762:
601:
473:
353:
286:
247:
167:
113:
73:
46:
3932:
3431:
Gamper G, Havel C, Arrich J, Losert H, Pace NL, MĂĽllner M, Herkner H (February 2016).
5489:
5363:
5358:
5281:
5176:
5171:
5144:
5010:
4756:
4556:
4534:
4519:
4410:
4332:
4280:
4150:
4072:
4064:
4056:
4046:
3971:
3889:
3858:
3850:
3786:
3758:
3701:
3652:
3644:
3595:
3557:
3497:
3462:
3413:
3395:
3348:
3308:
3270:
3247:
3206:
3155:
3120:
3085:
3032:
3024:
2993:
2933:
2883:
2832:
2747:
2737:
2699:
2689:
2666:
2613:
2605:
2555:
2547:
2500:
2492:
2453:
2392:
2284:
2256:
2210:
2172:
2134:
2109:
2072:
2023:
1795:
1716:
1707:
Aggressive intravenous fluids are recommended in most types of shock (e.g. 1–2 liter
1684:
1383:
1367:
1338:
1306:
1290:
1289:
Shock is a common end point of many medical conditions. Shock triggered by a serious
1198:
1180:
736:
725:
720:
694:
661:
626:
621:
574:
449:
444:
376:
306:
302:
298:
282:
278:
274:
205:
178:
151:
143:
109:
105:
61:
4190:
3607:
3509:
3360:
3132:
2625:
2567:
2512:
2184:
1541:
1088:
5594:
5565:
5406:
5293:
5286:
5271:
5114:
4868:
4539:
4260:
4030:
3967:
3928:
3840:
3748:
3740:
3713:
3691:
3664:
3634:
3587:
3547:
3543:
3539:
3489:
3452:
3448:
3444:
3403:
3391:
3387:
3340:
3237:
3196:
3192:
3188:
3112:
3075:
3065:
2985:
2873:
2863:
2824:
2658:
2595:
2539:
2484:
2443:
2433:
2164:
1866:
1803:
1799:
1448:
1412:
1144:
1033:
946:
920:
876:
806:
690:
681:
567:
420:
388:
322:
243:
5321:
2309:. National Collaborating Centre for Women's and Children's Health (UK). April 2009
1568:, bacteria may enter the blood stream, resulting in the increased complication of
1556:
into the surrounding tissues. As this fluid is lost, the blood concentration and
5650:
5622:
5583:
5527:
5520:
5503:
5465:
5431:
4894:
4792:
4666:
4144:
4021:. Proceedings of a Symposium Held in Oklahoma City, Oklahoma, October 1–2, 1971.
3989:
3880:
3591:
3493:
3344:
2649:
2543:
2438:
1964:
1963:
of shock. Of the various theories, the most well regarded was a theory penned by
1960:
1834:
1395:
1194:
990:
977:
819:
Cool, clammy, mottled skin, often due to low blood pressure and vasoconstriction.
772:
357:
263:
251:
87:
4196:
2989:
993:, oliguria, or an acute alteration in mental status. Patients who are receiving
81:: Weakness, fast heart rate, fast breathing, sweating, anxiety, increased thirst
5461:
5456:
5379:
5331:
5005:
4848:
4625:
4155:
3242:
3225:
3177:"Colloids versus crystalloids for fluid resuscitation in critically ill people"
2414:"A systematic review of the relationship between blood loss and clinical signs"
2366:"Shock: A Common Pathway For Life-Threatening Pediatric Illnesses And Injuries"
2304:
1668:
1628:
1468:
1444:
1346:
1313:, etc. Shock itself is a life-threatening condition as a result of compromised
1217:
1202:
1184:
1176:
1112:
638:
337:
267:
255:
91:
4193:
4034:
3744:
3070:
2905:"Definition, classification, etiology, and pathophysiology of shock in adults"
2828:
2600:
2583:
2488:
1971:, that shock was quintessentially defined as a state of circulatory collapse (
980:. Septic shock also includes some elements of cardiogenic shock. In 1992, the
5730:
5687:
5643:
5616:
5241:
5154:
5104:
4733:
4716:
4342:
4314:
4060:
4042:
3854:
3648:
3399:
3028:
2997:
2703:
2662:
2639:
Bone RC, Balk RA, et al. (The ACCP/SCCM Consensus
Conference Committee.
2609:
2551:
2496:
1949:
1826:
1779:
1708:
1651:
or emergency department ultrasound may be useful to determine volume status.
1609:
1581:
1549:
1428:
1363:
965:
941:
729:
184:
139:
4118:
3796:
3526:
MartĂ-Carvajal AJ, SolĂ I, Gluud C, Lathyris D, Cardona AF (December 2012).
2751:
2209:(11th ed.). Philadelphia, Pennsylvania: Elsevier Inc. pp. 278–88.
2168:
431:, weak peripheral pulses, and cold extremities can be early signs of shock.
5532:
5451:
5309:
5161:
5134:
5126:
5042:
4943:
4810:
4802:
4748:
4650:
4640:
4544:
4501:
4496:
4337:
4255:
3845:
3828:
3762:
3705:
3656:
3599:
3561:
3501:
3466:
3417:
3352:
3312:
3251:
3210:
3124:
3089:
3012:
2887:
2836:
2730:
Kumar, Vinay; Abbas, Abul K.; Fausto, Nelson; Mitchell, Richard N. (2007).
2617:
2559:
2504:
2457:
2176:
2138:
1972:
1925:
1900:
1875:(ECMO) – an external device that completely replaces the work of the heart.
1811:
1771:
1660:
1601:
1585:
1569:
1464:
1386:, resulting in its accumulation. The accumulating pyruvate is converted to
1310:
1156:
1082:
which causes widespread vasodilation, leading to hypotension and increased
973:
937:
933:
927:
908:
669:
453:
452:
is the most common type of shock and is caused by insufficient circulating
413:
409:
392:
372:
294:
289:. Hypovolemic shock, also known as low volume shock, may be from bleeding,
209:
135:
127:
4358:
4076:
3862:
3696:
3679:
3639:
3622:
3036:
2670:
1019:
The main manifestations of septic shock are due to the massive release of
5480:
5442:
5368:
5266:
5261:
5231:
5083:
5025:
4948:
4529:
4309:
4174:
2731:
1956:
1937:
1732:
1696:
1687:
added if blood loss is severe. In select cases, compression devices like
1648:
1644:
1537:
1504:
1456:
1440:
1436:
1387:
1350:
1298:
1188:
1160:
1148:
1063:
1037:
1014:
969:
916:
810:
750:
740:
699:
685:
642:
609:
587:
561:
457:
440:
424:
405:
349:
318:
2129:
Smith, N; Lopez, RA; Silberman, M (January 2019). "Distributive Shock".
2071:(10 ed.). American College of Surgeons. 2018. pp. 43–52, 135.
1423:
indirectly acts to acidify the blood, so the body attempts to return to
5338:
5096:
5032:
5015:
4927:
4843:
4787:
4593:
4304:
3919:
3096:
2736:(8th ed.). Philadelphia, PA: Saunders/Elsevier. pp. 102–103.
1838:
1787:
1725:
1664:
1620:
The diagnosis of shock is commonly based on a combination of symptoms,
1533:
1460:
1452:
1302:
866:
765:
is the result of a thromboembolic incident in the blood vessels of the
560:
A rapid, weak, thready pulse due to decreased blood flow combined with
239:
200:
4101:
3267:
Rosen's emergency medicine: concepts and clinical practice 7th edition
3116:
1499:. The lack of blood to the renal system causes the characteristic low
5314:
5020:
4902:
4838:
4185:
1842:
1748:
1605:
1593:
1557:
1545:
1521:
1095:
Signs typically occur after exposure to an allergen and may include:
1079:
1020:
998:
961:
591:
368:
273:
Shock is divided into four main types based on the underlying cause:
216:
604:), especially extremities, due to insufficient perfusion of the skin
363:
Treatment of shock is based on the likely underlying cause. An open
262:, anxiety, and increased thirst. This may be followed by confusion,
56:
in treating a trauma training mannequin to prevent hypovolemic shock
5637:
5139:
4922:
4873:
4853:
4711:
4630:
4405:
2957:(2nd ed.). In: Alexander, M.F., Fawcett, J.N., Runciman, P.J.
2868:
1915:
1830:
1783:
1712:
1565:
1561:
1408:
1379:
1233:
1131:
1120:
1116:
1067:
1045:
994:
822:
582:
465:
461:
326:
290:
259:
171:
5037:
4917:
2580:
1810:(Xigris), while once aggressively promoted for the management of
1553:
1071:
784:
is overly thick ventricular muscle that dynamically occludes the
4068:
3893:
3785:. Lippincott Williams & Wilkins, Philadelphia & London.
2154:
2022:(8 ed.). Pearson Education Limited. 2018. pp. 172–73.
1163:
after injury and does not refer to the hemodynamic instability.)
861:<36 °C (96.8 °F) or >38 °C (100.4 °F)
5574:
5544:
5109:
4491:
4113:
3525:
2972:
Lembke, Kelly; Parashar, Sanjay; Simpson, Steven (2017-10-01).
1517:
1484:
1432:
912:
895:<4x10/L (<4000/mm), >12x10/L (>12,000/mm), or ≥10%
795:
728:
is a form of shock associated with physical obstruction of the
364:
332:
The diagnosis is generally based on a combination of symptoms,
314:
163:
3726:
2020:
International Trauma Life
Support for Emergency Care Providers
1325:
5253:
5236:
3813:
The Nature and
Treatment of Wound Shock and Allied Conditions
2102:
High Risk
Emergencies, An Issue of Emergency Medicine Clinics
1500:
1496:
1492:
1480:
1099:
3145:
3049:
2411:
1627:
Shock is hemodynamically speaking, inadequate blood flow or
5674:
4912:
4598:
3826:
3297:"Traumatic Hemorrhagic Shock: Advances In Fluid Management"
2069:
ATLS – Advanced Trauma Life Support – Student Course Manual
1592:(the basic energy source for cells) has been degraded into
1337:
One of the key dangers of shock is that it progresses by a
1075:
911:
within the body. This can be caused by systemic infection (
766:
352:(SI), of greater than 0.8 supports the diagnosis more than
4990:
European Society of Paediatric and Neonatal Intensive Care
3103:
Nolan JP, Pullinger R (March 2014). "Hypovolaemic shock".
3174:
1821:
People with anaphylactic shock are commonly treated with
1763:
1483:
system. These hormones cause the vasoconstriction of the
4208:
2804:
2729:
1596:
in the absence of oxygen as an electron receptor in the
743:
prevents inflow of blood into the heart (venous return).
3998:
Special Report Series, Medical Research Council, London
3430:
3373:
1845:, normal saline, and steroids are also commonly given.
126:: Severe bleeding, vomiting, diarrhea, dehydration, or
4015:
Hinshaw, Lerner B.; Cox, Barbara G. (1 October 1971).
3148:
ATLS, Advanced Trauma Life Support Program for Doctors
2638:
1747:
of 70–90 mmHg, or until the patient has adequate
1374:. Since oxygen, the terminal electron acceptor in the
940:
leading to hypotension. Septic shock can be caused by
4621:
Critical illness–related corticosteroid insufficiency
3978:
2971:
2927:
2766:"Surviving Sepsis Campaign Responds to ProCESS Trial"
2386:
2278:
2250:
1959:, there were several competing hypotheses behind the
1183:) in people who are critically ill patients, reduces
138:(especially of the left or right ventricles), severe
4091:
3778:
2283:. New York: McGraw-Hill Companies. pp. 174–75.
2255:. New York: McGraw-Hill Companies. pp. 165–72.
1467:
tone; the combined effect results in an increase in
4025:. Vol. 23. United States Navy Project THEMIS,
3779:Irwin, Richard S.; Rippe, James M. (January 2003).
2128:
1520:ions build up within the intracellular space while
533:
very fast heart rate, low blood pressure, confusion
3521:
3519:
3269:. Philadelphia, PA: Mosby/Elsevier. p. 2467.
250:. Initial symptoms of shock may include weakness,
3912:"The condition of the blood vessels during shock"
1491:, and other organs to divert blood to the heart,
1362:During the Initial stage (Stage 1), the state of
556:Signs and symptoms of hypovolemic shock include:
293:, or vomiting. Cardiogenic shock may be due to a
5728:
3677:
3620:
3043:
2932:. New York: McGraw-Hill Companies. p. 168.
2899:
2897:
1329:Effects of inadequate perfusion on cell function
753:shrinks and hardens, is similar in presentation.
456:. The most common cause of hypovolemic shock is
3951:"The Course of Events in Secondary Wound Shock"
3516:
2959:Nursing Practice. Hospital and Home. The Adult.
2930:Emergency Medicine: A Comprehensive Study Guide
2389:Emergency Medicine: A Comprehensive Study Guide
2281:Emergency Medicine: A Comprehensive Study Guide
2253:Emergency Medicine: A Comprehensive Study Guide
1370:. Due to the lack of oxygen, the cells perform
1159:which is a recoverable loss of function of the
387:, is often given. Efforts to maintain a normal
3102:
1659:The best evidence exists for the treatment of
1415:in order to rid the body of carbon dioxide (CO
5069:
4374:
4224:
4027:University of Oklahoma Health Sciences Center
4023:Advances in Experimental Medicine and Biology
3984:
3774:
3772:
3329:
2894:
2098:
1969:An Experimental Research into Surgical Shock"
1283:Abnormal flow within the small blood vessels
976:, and certain fungi as well as Gram-positive
769:and hinders the return of blood to the heart.
246:of the body as a result of problems with the
3994:"Note on Muscle Injury in Relation to Shock"
3882:An Experimental Research Into Surgical Shock
3223:
2683:
2014:
2012:
2010:
2008:
1643:will begin to occur with an increased blood
1510:
1378:, is not abundant, this slows down entry of
1236:are insufficient to meet the higher demands.
1216:) is frequently the result of discontinuing
1078:, or foreign protein causing the release of
633:. Other causes of cardiogenic shock include
597:Thirst and dry mouth, due to fluid depletion
16:Medical condition of insufficient blood flow
4388:
4008:
3959:Journal of the American Medical Association
3573:
3571:
3532:The Cochrane Database of Systematic Reviews
3437:The Cochrane Database of Systematic Reviews
3380:The Cochrane Database of Systematic Reviews
3181:The Cochrane Database of Systematic Reviews
2807:Emergency Medicine Clinics of North America
2800:
2798:
2796:
2632:
2063:
2061:
2059:
2006:
2004:
2002:
2000:
1998:
1996:
1994:
1992:
1990:
1988:
1275:Blood flow to or from the heart is blocked
1232:) in critically ill patients where present
505:min. fast heart rate, normal blood pressure
5076:
5062:
4381:
4367:
4231:
4217:
4014:
3769:
3577:
3230:The American Journal of Emergency Medicine
2849:
2725:
2723:
2721:
2719:
2717:
2715:
2713:
2470:
2297:
2274:
2272:
2204:
2150:
2148:
2122:
2057:
2055:
2053:
2051:
2049:
2047:
2045:
2043:
2041:
2039:
37:
3939:
3844:
3752:
3695:
3638:
3551:
3479:
3456:
3407:
3258:
3241:
3200:
3079:
3069:
3010:
2952:
2946:
2877:
2867:
2818:
2599:
2447:
2437:
2363:
2246:
2094:
2092:
2090:
2088:
1584:and the shock can no longer be reversed.
1580:At Refractory stage (stage 4), the vital
1001:adhesion to endothelial cells 2) Reduced
3678:Vincent JL, De Backer D (October 2013).
3568:
3290:
3288:
3286:
2793:
2525:
2359:
2357:
2355:
2353:
2351:
2349:
2347:
2345:
2343:
2244:
2242:
2240:
2238:
2236:
2234:
2232:
2230:
2228:
2226:
2200:
2198:
2196:
2194:
2108:. Elsevier Health Sciences. p. 58.
1985:
1914:
1762:
1324:
1267:Ineffective pumping due to heart damage
1259:Fluid loss such as bleeding or diarrhea
1087:
519:fast heart rate, min. low blood pressure
3909:
3903:
3294:
3168:
2758:
2710:
2269:
2145:
2099:Tabas, Jeffrey; Reynolds, Teri (2010).
2036:
1427:by removing that acidifying agent. The
842:Systemic inflammatory response syndrome
775:hinders circulation by obstructing the
5729:
3945:
3809:
2085:
1967:who suggested in his 1899 monograph, "
1524:ions leak out. Due to lack of oxygen,
1447:. Norepinephrine causes predominately
1011:disseminated intravascular coagulation
547:critical blood pressure and heart rate
5057:
4362:
4212:
3910:Malcolm, John D (23 September 1905).
3875:
3869:
3829:"Theories of the Production of Shock"
3283:
3146:American College of Surgeons (2008).
2775:. Survivingsepsis.org. Archived from
2370:Pediatric Emergency Medicine Practice
2340:
2223:
2191:
1848:
1755:may also be an option in this group.
1536:relax such that blood remains in the
1309:, shock caused by sepsis is known as
399:
4869:Recombinant activated protein C
3433:"Vasopressors for hypotensive shock"
3376:"Vasopressors for hypotensive shock"
3264:
2641:American College of Chest Physicians
2526:Cheatham, Michael Lee (April 2009).
1564:. If the bowel becomes sufficiently
1459:predominately causes an increase in
336:, and laboratory tests. A decreased
4582:Multiple organ dysfunction syndrome
4567:Acute respiratory distress syndrome
4507:Multiple organ dysfunction syndrome
4018:The Fundamental mechanisms of shock
3684:The New England Journal of Medicine
2961:: Edinburgh: Churchill Livingstone.
2471:Pich, H.; Heller, A.R. (May 2015).
2391:. New York: McGraw-Hill Companies.
1873:Extracorporeal membrane oxygenation
1724:should be administered to keep the
570:and stimulation of vasoconstriction
313:. Distributive shock may be due to
13:
2677:
1879:
1394:. The accumulating lactate causes
1320:
1102:, itching, flushing, and swelling.
14:
5758:
4980:Society of Critical Care Medicine
4677:Ventilator-associated lung injury
4087:
2688:. Jones & Bartlett Learning.
2645:Society of Critical Care Medicine
1689:non-pneumatic anti-shock garments
1544:will increase and, combined with
460:(internal or external); however,
3972:10.1001/jama.1919.02610290016008
3810:Cannon, Walter Bradford (1918).
3580:Current Opinion in Critical Care
3482:Current Opinion in Critical Care
2532:Current Opinion in Critical Care
2528:"Abdominal compartment syndrome"
1841:are also commonly administered.
1637:Central venous oxygen saturation
944:bacteria such as (among others)
885:<32 mmHg (4.3 kPa)
782:Hypertrophic sub-aortic stenosis
4682:Ventilator-associated pneumonia
4615:Critical illness polyneuropathy
3820:
3816:. American Medical Association.
3803:
3720:
3671:
3627:New England Journal of Medicine
3614:
3473:
3424:
3367:
3323:
3217:
3139:
3004:
2965:
2921:
2843:
2574:
2519:
2464:
2405:
2380:
2306:Assessing dehydration and shock
1895:
1604:, and then is transformed into
1401:
1143:High spinal injuries may cause
1030:Signs of septic shock include:
915:), a severe allergic reaction (
907:is low blood pressure due to a
829:
323:injury to the upper spinal cord
4289:Abdominal compartment syndrome
3833:British Journal of Anaesthesia
3544:10.1002/14651858.CD004388.pub6
3449:10.1002/14651858.CD003709.pub4
3392:10.1002/14651858.CD003709.pub4
3193:10.1002/14651858.CD000567.pub7
2928:Tintinalli, Judith E. (2010).
2686:Wilderness and rescue medicine
2387:Tintinalli, Judith E. (2010).
2279:Tintinalli, Judith E. (2010).
2251:Tintinalli, Judith E. (2010).
2207:Textbook of Medical Physiology
2157:Emergency Medicine Australasia
1758:
1633:Mixed venous oxygen saturation
1191:and respiratory insufficiency.
792:Abdominal compartment syndrome
714:
615:
1:
4461:Geriatric intensive-care unit
4444:Pediatric intensive care unit
3933:10.1016/S0140-6736(00)69075-X
3017:New Horizons (Baltimore, Md.)
3011:Shoemaker, W. C. (May 1996).
1978:
1654:
1575:
1179:(can be considered a form of
434:
238:is the state of insufficient
195:Based on the underlying cause
4864:Neuromuscular-blocking drugs
4807:Nutritional supplementation
4438:Neonatal intensive care unit
3592:10.1097/MCC.0b013e3283069d5c
3494:10.1097/MCC.0b013e328331a8a7
3345:10.1213/ANE.0000000000002451
2544:10.1097/MCC.0b013e3283297934
2439:10.1371/journal.pone.0057594
2364:Silverman, Adam (Oct 2005).
1910:
1693:military anti-shock trousers
1615:
1297:, shock triggered by severe
1167:
7:
5704:superior vena cava syndrome
4964:Water-electrolyte imbalance
4798:Early goal-directed therapy
3301:Emergency Medicine Practice
3295:Cherkas, David (Nov 2011).
2990:10.1016/j.chest.2017.08.427
1728:greater than 100 g/L.
1463:with a small effect on the
1411:, the person will begin to
270:, as complications worsen.
52:trainees and firemen using
10:
5763:
4816:Total parenteral nutrition
4749:Life-supporting treatments
4456:Critical illness insurance
3887:J. B. Lippincott & Co.
3243:10.1016/j.ajem.2019.02.045
2850:Elbers PW, Ince C (2006).
1931:
1357:
1201:) may induce a reversible
1003:contractility of the heart
925:
919:), or spinal cord injury (
833:
718:
619:
579:sympathetic nervous system
438:
18:
5673:
5617:radial artery sufficiency
5573:
5564:
5512:
5479:
5440:
5397:
5388:
5349:
5302:
5252:
5125:
5095:
4998:
4985:Surviving Sepsis Campaign
4972:
4936:
4893:
4831:
4781:Ventricular assist device
4776:Intra-aortic balloon pump
4747:
4727:Pulmonary artery catheter
4699:
4649:
4607:
4476:
4469:
4424:
4396:
4325:
4297:
4279:
4246:
4238:
4165:
4095:
4035:10.1007/978-1-4615-9014-9
3745:10.1007/s00134-014-3525-z
3071:10.1186/s12978-018-0613-5
2829:10.1016/j.emc.2007.06.001
2773:Surviving Sepsis Campaign
2601:10.1007/s00134-007-0592-4
2489:10.1007/s00101-015-0031-9
1861:Ventricular assist device
1855:Intra-aortic balloon pump
1767:Epinephrine auto-injector
1702:
1511:Progressive/decompensated
909:dilation of blood vessels
786:ventricular outflow tract
777:ventricular outflow tract
747:Constrictive pericarditis
550:aggressive interventions
229:1.2 million per year (US)
225:
215:
199:
191:
177:
119:
97:
72:
60:
45:
36:
31:
5227:Pericardial friction rub
3333:Anesthesia and Analgesia
3307:(11): 1–19, quiz 19–20.
3152:Amer College of Surgeons
2953:Armstrong, D.J. (2004).
2663:10.1378/chest.101.6.1644
1888:of 8–12 mmHg and a
1683:) should be started and
1451:with a mild increase in
1376:electron transport chain
1372:lactic acid fermentation
1240:
1013:4). Increased levels of
647:congestive heart failure
594:and evaporation of sweat
516:15–30% (0.75–1.5 L)
346:diastolic blood pressure
5737:Intensive care medicine
5663:Nicoladoni–Branham sign
5327:Jugular venous pressure
5189:Pulmonary insufficiency
4879:Stress ulcer prevention
4823:Therapeutic hypothermia
4722:Central venous catheter
4390:Intensive care medicine
3782:Intensive Care Medicine
3733:Intensive Care Medicine
2733:Robbins Basic Pathology
2588:Intensive Care Medicine
2169:10.1111/1742-6723.12232
1886:central venous pressure
1751:and peripheral pulses.
1745:systolic blood pressure
1151:due to loss of cardiac
816:Reduced blood pressure.
674:jugular venous pressure
600:Cold and mottled skin (
536:fluids and packed RBCs
342:systolic blood pressure
221:Risk of death 20 to 50%
5552:Gallavardin phenomenon
5390:Cardiovascular disease
4954:Level of consciousness
4761:mechanical ventilation
4659:Methicillin-resistant
1920:
1890:mean arterial pressure
1768:
1741:mean arterial pressure
1737:permissive hypotension
1722:packed red blood cells
1681:Trendelenburg position
1669:Oxygen supplementation
1548:release, will lead to
1489:gastrointestinal tract
1473:renin–angiotensin axis
1330:
1098:Skin changes, such as
1093:
1084:capillary permeability
1062:is caused by a severe
1046:Decreased urine output
1042:Reduced blood pressure
1034:Abnormal heart rhythms
823:Decreased urine output
807:Abnormal heart rhythms
739:in which fluid in the
700:Reduced blood pressure
682:Abnormal heart rhythms
655:valvular heart disease
544:>40% (>2 L)
385:packed red blood cells
67:Critical care medicine
21:Shock (disambiguation)
5657:arteriovenous fistula
5471:Bracht–Wachter bodies
4661:Staphylococcus aureus
3697:10.1056/NEJMra1208943
3640:10.1056/NEJMra1208943
2684:Isaac, Jeff. (2013).
2473:"Obstruktiver Schock"
2131:StatPearls (Internet)
1946:Henri-François LeDran
1918:
1802:but may be of use in
1766:
1739:). Targets include a
1735:to persist (known as
1425:acid–base homeostasis
1392:lactate dehydrogenase
1388:lactate (lactic acid)
1328:
1226:adrenal insufficiency
1210:adrenal insufficiency
1136:loss of consciousness
1091:
1064:anaphylactic reaction
1051:Altered mental status
1005:3) Activation of the
957:Klebsiella pneumoniae
631:myocardial infarction
530:30–40% (1.5–2 L)
502:<15% (0.75 L)
470:diabetic ketoacidosis
429:capillary refill time
5494:Pericardial effusion
5399:Aortic insufficiency
5212:Mitral insufficiency
5194:Graham Steell murmur
4636:Stress hyperglycemia
4477:Organ system failure
4411:Medical specialities
4271:Toxic shock syndrome
3885:. Philadelphia, PA:
3846:10.1093/bja/38.4.234
1641:anaerobic metabolism
1622:physical examination
1598:mitochondrial matrix
1542:hydrostatic pressure
1530:anaerobic metabolism
1526:cellular respiration
1507:mediation of shock.
1477:arginine vasopressin
1345:As such, shock is a
1092:Signs of anaphylaxis
1007:coagulation pathways
757:Tension pneumothorax
709:pulmonary congestion
678:Weak or absent pulse
651:myocardial contusion
391:are also important.
334:physical examination
311:tension pneumothorax
156:tension pneumothorax
54:IV fluid replacement
19:For other uses, see
5742:Medical emergencies
5427:Austin Flint murmur
5206:Carey Coombs murmur
4999:Related specialties
4959:Acid–base imbalance
4895:ICU scoring systems
4766:Tracheal intubation
4577:Respiratory failure
4572:Acute liver failure
4562:Acute renal failure
4432:Intensive care unit
4416:Respiratory therapy
3680:"Circulatory shock"
3623:"Circulatory Shock"
3057:Reproductive Health
2430:2013PLoSO...857594P
1905:intensive care unit
1808:Activated protein C
1743:of 60 mmHg, a
1691:(or the deprecated
1677:passive leg raising
1540:. Due to this, the
1107:shortness of breath
844:
705:Shortness of breath
522:intravenous fluids
488:Blood loss (liters)
481:
480:Hemorrhage classes
183:Based on symptoms,
5698:Trendelenburg test
5631:pseudohypertension
5609:Right heart strain
5603:pulmonary embolism
5218:Presystolic murmur
5089:circulatory system
5085:Signs and symptoms
4908:Glasgow Coma Scale
4859:Intravenous fluids
4739:Screening cultures
4707:Arterial blood gas
4672:Refeeding syndrome
4589:Neonatal infection
4550:Vasodilatory shock
4525:Distributive shock
4450:Coronary care unit
4348:Vasodilatory shock
4266:Anaphylactic shock
4166:External resources
3111:(mar07 1): g1139.
2813:(3): 623–42, vii.
1921:
1849:Mechanical support
1816:sodium bicarbonate
1769:
1685:blood transfusions
1673:intravenous fluids
1582:organs have failed
1475:is activated, and
1331:
1295:anaphylactic shock
1230:distributive shock
1214:distributive shock
1094:
1060:Anaphylactic shock
905:Distributive shock
840:
836:Distributive shock
763:Pulmonary embolism
602:livedo reticularis
479:
474:diabetes insipidus
406:low blood pressure
400:Signs and symptoms
354:low blood pressure
287:distributive shock
248:circulatory system
187:, laboratory tests
168:spinal cord injury
5724:
5723:
5720:
5719:
5683:Friedreich's sign
5590:Cardarelli's sign
5560:
5559:
5490:Cardiac tamponade
5282:Pulsus bisferiens
5172:Functional murmur
5051:
5050:
5011:Internal medicine
4757:Airway management
4695:
4694:
4535:Obstructive shock
4520:Cardiogenic shock
4356:
4355:
4206:
4205:
3927:(4282): 922–923.
3792:978-0-7817-3548-3
3276:978-0-323-05472-0
3161:978-1-880696-31-6
3117:10.1136/bmj.g1139
2939:978-0-07-148480-0
2743:978-1-4160-2973-1
2398:978-0-07-148480-0
2290:978-0-07-148480-0
2262:978-0-07-148480-0
2216:978-0-7216-0240-0
1796:hemorrhagic shock
1562:reduced perfusion
1339:positive feedback
1307:hypovolemic shock
1291:allergic reaction
1287:
1286:
1199:cardiogenic shock
1181:cardiogenic shock
1149:a slow heart rate
1126:Lightheadedness,
902:
901:
737:Cardiac tamponade
726:Obstructive shock
721:Obstructive shock
672:due to increased
662:cardiogenic shock
627:Cardiogenic shock
622:Cardiogenic shock
590:due to decreased
575:shallow breathing
566:Cool skin due to
554:
553:
450:Hypovolemic shock
445:Hypovolemic shock
377:Intravenous fluid
307:cardiac tamponade
303:Obstructive shock
299:cardiac contusion
233:
232:
206:Intravenous fluid
179:Diagnostic method
152:Cardiac tamponade
144:cardiac contusion
26:Medical condition
5754:
5710:Pemberton's sign
5571:
5570:
5566:Vascular disease
5412:De Musset's sign
5407:Collapsing pulse
5395:
5394:
5294:Pulsus alternans
5287:Pulsus bigeminus
5272:Pulsus paradoxus
5087:relating to the
5078:
5071:
5064:
5055:
5054:
4772:Cardiac devices
4626:Decubitus ulcers
4540:Neurogenic shock
4474:
4473:
4383:
4376:
4369:
4360:
4359:
4261:Neurogenic shock
4233:
4226:
4219:
4210:
4209:
4093:
4092:
4081:
4080:
4012:
4006:
4005:
3982:
3976:
3975:
3955:
3949:(19 July 1919).
3943:
3937:
3936:
3916:
3907:
3901:
3897:
3877:Crile, George W.
3873:
3867:
3866:
3848:
3824:
3818:
3817:
3807:
3801:
3800:
3795:. Archived from
3776:
3767:
3766:
3756:
3739:(12): 1795–815.
3724:
3718:
3717:
3699:
3675:
3669:
3668:
3642:
3618:
3612:
3611:
3575:
3566:
3565:
3555:
3538:(12): CD004388.
3523:
3514:
3513:
3477:
3471:
3470:
3460:
3428:
3422:
3421:
3411:
3371:
3365:
3364:
3327:
3321:
3320:
3315:. Archived from
3292:
3281:
3280:
3265:Marx, J (2010).
3262:
3256:
3255:
3245:
3221:
3215:
3214:
3204:
3172:
3166:
3165:
3143:
3137:
3136:
3100:
3094:
3093:
3083:
3073:
3047:
3041:
3040:
3008:
3002:
3001:
2969:
2963:
2962:
2950:
2944:
2943:
2925:
2919:
2918:
2916:
2915:
2901:
2892:
2891:
2881:
2871:
2847:
2841:
2840:
2822:
2802:
2791:
2790:
2788:
2787:
2781:
2770:
2762:
2756:
2755:
2727:
2708:
2707:
2681:
2675:
2674:
2636:
2630:
2629:
2603:
2578:
2572:
2571:
2523:
2517:
2516:
2477:Der Anaesthesist
2468:
2462:
2461:
2451:
2441:
2409:
2403:
2402:
2384:
2378:
2377:
2361:
2338:
2337:
2331:
2327:
2325:
2317:
2315:
2314:
2301:
2295:
2294:
2276:
2267:
2266:
2248:
2221:
2220:
2202:
2189:
2188:
2152:
2143:
2142:
2126:
2120:
2119:
2107:
2096:
2083:
2082:
2078:978-78-0-9968267
2065:
2034:
2033:
2029:978-1292-17084-8
2016:
1919:Sepsis mortality
1867:Artificial heart
1804:neurogenic shock
1753:Hypertonic fluid
1550:leakage of fluid
1449:vasoconstriction
1315:body circulation
1245:
1244:
1187:and can lead to
1153:sympathetic tone
1145:neurogenic shock
978:bacterial toxins
947:Escherichia coli
921:neurogenic shock
877:Respiratory rate
845:
839:
691:Pulsus paradoxus
581:stimulation and
568:vasoconstriction
482:
478:
389:body temperature
381:Ringer's lactate
41:
29:
28:
5762:
5761:
5757:
5756:
5755:
5753:
5752:
5751:
5747:Causes of death
5727:
5726:
5725:
5716:
5693:Kussmaul's sign
5669:
5584:aortic aneurysm
5556:
5528:Anitschkow cell
5521:rheumatic fever
5508:
5475:
5436:
5417:Duroziez's sign
5384:
5345:
5298:
5248:
5121:
5091:
5082:
5052:
5047:
4994:
4968:
4932:
4889:
4849:Antithrombotics
4827:
4811:Enteral feeding
4793:Kidney dialysis
4743:
4691:
4667:Oxygen toxicity
4645:
4603:
4465:
4420:
4392:
4387:
4357:
4352:
4321:
4293:
4275:
4242:
4237:
4207:
4202:
4201:
4161:
4160:
4104:
4090:
4085:
4084:
4053:
4013:
4009:
3983:
3979:
3953:
3944:
3940:
3914:
3908:
3904:
3874:
3870:
3825:
3821:
3808:
3804:
3793:
3777:
3770:
3725:
3721:
3690:(18): 1726–34.
3676:
3672:
3633:(18): 1726–34.
3619:
3615:
3576:
3569:
3524:
3517:
3478:
3474:
3443:(2): CD003709.
3429:
3425:
3386:(2): CD003709.
3372:
3368:
3328:
3324:
3293:
3284:
3277:
3263:
3259:
3236:(11): 2072–78.
3222:
3218:
3187:(8): CD000567.
3173:
3169:
3162:
3144:
3140:
3101:
3097:
3048:
3044:
3009:
3005:
2970:
2966:
2951:
2947:
2940:
2926:
2922:
2913:
2911:
2903:
2902:
2895:
2848:
2844:
2820:10.1.1.688.9838
2803:
2794:
2785:
2783:
2779:
2768:
2764:
2763:
2759:
2744:
2728:
2711:
2696:
2682:
2678:
2637:
2633:
2579:
2575:
2524:
2520:
2469:
2465:
2410:
2406:
2399:
2385:
2381:
2362:
2341:
2329:
2328:
2319:
2318:
2312:
2310:
2303:
2302:
2298:
2291:
2277:
2270:
2263:
2249:
2224:
2217:
2203:
2192:
2153:
2146:
2127:
2123:
2116:
2105:
2097:
2086:
2079:
2067:
2066:
2037:
2030:
2018:
2017:
1986:
1981:
1965:George W. Crile
1961:pathophysiology
1950:gun-shot wounds
1934:
1913:
1898:
1882:
1880:Treatment goals
1851:
1835:diphenhydramine
1761:
1705:
1657:
1618:
1578:
1570:endotoxic shock
1528:diminishes and
1513:
1422:
1418:
1404:
1396:lactic acidosis
1360:
1323:
1321:Pathophysiology
1243:
1170:
1038:fast heart rate
1009:, resulting in
991:lactic acidosis
968:cocci, such as
960:(which have an
930:
838:
832:
811:fast heart rate
773:Aortic stenosis
749:, in which the
723:
717:
686:fast heart rate
624:
618:
447:
439:Main articles:
437:
421:mucous membrane
402:
367:and sufficient
358:fast heart rate
264:unconsciousness
252:fast heart rate
158:
146:
130:
88:unconsciousness
82:
27:
24:
17:
12:
11:
5:
5760:
5750:
5749:
5744:
5739:
5722:
5721:
5718:
5717:
5715:
5714:
5713:
5712:
5700:
5695:
5690:
5685:
5679:
5677:
5671:
5670:
5668:
5667:
5666:
5665:
5653:
5648:
5647:
5646:
5634:
5627:
5626:
5625:
5613:
5612:
5611:
5599:
5598:
5597:
5592:
5579:
5577:
5568:
5562:
5561:
5558:
5557:
5555:
5554:
5549:
5548:
5547:
5535:
5530:
5525:
5516:
5514:
5510:
5509:
5507:
5506:
5501:
5485:
5483:
5477:
5476:
5474:
5473:
5468:
5462:Janeway lesion
5459:
5447:
5445:
5438:
5437:
5435:
5434:
5429:
5424:
5419:
5414:
5409:
5403:
5401:
5392:
5386:
5385:
5383:
5382:
5380:Template:Shock
5376:
5371:
5366:
5361:
5355:
5353:
5347:
5346:
5344:
5343:
5341:
5336:
5335:
5334:
5332:Cannon A waves
5324:
5319:
5318:
5317:
5306:
5304:
5300:
5299:
5297:
5296:
5291:
5290:
5289:
5284:
5274:
5269:
5264:
5258:
5256:
5250:
5249:
5247:
5246:
5245:
5244:
5234:
5229:
5224:
5223:
5222:
5221:
5220:
5208:
5203:
5198:
5197:
5196:
5191:
5181:
5180:
5179:
5177:Still's murmur
5174:
5159:
5158:
5157:
5152:
5147:
5142:
5131:
5129:
5123:
5122:
5120:
5119:
5118:
5117:
5107:
5101:
5099:
5093:
5092:
5081:
5080:
5073:
5066:
5058:
5049:
5048:
5046:
5045:
5040:
5035:
5030:
5029:
5028:
5023:
5018:
5008:
5006:Anesthesiology
5002:
5000:
4996:
4995:
4993:
4992:
4987:
4982:
4976:
4974:
4970:
4969:
4967:
4966:
4961:
4956:
4951:
4946:
4940:
4938:
4934:
4933:
4931:
4930:
4925:
4920:
4915:
4910:
4905:
4903:APACHE II
4899:
4897:
4891:
4890:
4888:
4887:
4882:
4876:
4871:
4866:
4861:
4856:
4851:
4846:
4841:
4835:
4833:
4829:
4828:
4826:
4825:
4820:
4819:
4818:
4813:
4805:
4800:
4795:
4790:
4785:
4784:
4783:
4778:
4770:
4769:
4768:
4753:
4751:
4745:
4744:
4742:
4741:
4736:
4734:Blood cultures
4731:
4730:
4729:
4724:
4719:
4709:
4703:
4701:
4697:
4696:
4693:
4692:
4690:
4689:
4684:
4679:
4674:
4669:
4664:
4655:
4653:
4647:
4646:
4644:
4643:
4638:
4633:
4628:
4623:
4618:
4611:
4609:
4605:
4604:
4602:
4601:
4596:
4591:
4585:
4584:
4579:
4574:
4569:
4564:
4559:
4553:
4552:
4547:
4542:
4537:
4532:
4527:
4522:
4517:
4510:
4509:
4504:
4499:
4494:
4489:
4484:
4483:Shock sequence
4480:
4478:
4471:
4467:
4466:
4464:
4463:
4458:
4453:
4447:
4441:
4435:
4428:
4426:
4422:
4421:
4419:
4418:
4413:
4408:
4403:
4401:Health science
4397:
4394:
4393:
4386:
4385:
4378:
4371:
4363:
4354:
4353:
4351:
4350:
4345:
4340:
4335:
4329:
4327:
4323:
4322:
4320:
4319:
4318:
4317:
4307:
4301:
4299:
4295:
4294:
4292:
4291:
4285:
4283:
4277:
4276:
4274:
4273:
4268:
4263:
4258:
4252:
4250:
4244:
4243:
4236:
4235:
4228:
4221:
4213:
4204:
4203:
4200:
4199:
4182:
4170:
4169:
4167:
4163:
4162:
4159:
4158:
4147:
4136:
4121:
4105:
4100:
4099:
4097:
4096:Classification
4089:
4088:External links
4086:
4083:
4082:
4051:
4007:
3990:Bayliss, W. M.
3977:
3938:
3902:
3868:
3819:
3802:
3799:on 2005-11-07.
3791:
3768:
3719:
3670:
3613:
3567:
3515:
3472:
3423:
3366:
3339:(5): 1549–57.
3322:
3319:on 2012-01-18.
3282:
3275:
3257:
3216:
3167:
3160:
3154:. p. 58.
3138:
3095:
3042:
3003:
2964:
2945:
2938:
2920:
2893:
2869:10.1186/cc4969
2842:
2792:
2757:
2742:
2709:
2694:
2676:
2657:(6): 1644–55.
2631:
2573:
2518:
2463:
2404:
2397:
2379:
2339:
2330:|website=
2296:
2289:
2268:
2261:
2222:
2215:
2190:
2144:
2121:
2115:978-1455700257
2114:
2084:
2077:
2035:
2028:
1983:
1982:
1980:
1977:
1940:used the word
1933:
1930:
1912:
1909:
1897:
1894:
1881:
1878:
1877:
1876:
1870:
1864:
1858:
1850:
1847:
1827:Antihistamines
1776:norepinephrine
1760:
1757:
1704:
1701:
1656:
1653:
1629:cardiac output
1617:
1614:
1577:
1574:
1512:
1509:
1469:blood pressure
1445:norepinephrine
1420:
1416:
1413:hyperventilate
1403:
1400:
1359:
1356:
1322:
1319:
1285:
1284:
1281:
1277:
1276:
1273:
1269:
1268:
1265:
1261:
1260:
1257:
1253:
1252:
1249:
1242:
1239:
1238:
1237:
1234:hormone levels
1222:
1218:corticosteroid
1206:
1203:cardiomyopathy
1195:Thyrotoxicosis
1192:
1185:cardiac output
1177:Hypothyroidism
1169:
1166:
1165:
1164:
1141:
1140:
1139:
1124:
1113:Abdominal pain
1110:
1103:
1057:
1056:
1055:
1054:
1053:
1048:
1043:
1040:
1028:
926:Main article:
900:
899:
893:
887:
886:
881:>20/min or
879:
873:
872:
869:
863:
862:
859:
853:
852:
849:
834:Main article:
831:
828:
827:
826:
820:
817:
814:
800:
799:
789:
779:
770:
760:
754:
744:
719:Main article:
716:
713:
712:
711:
702:
697:
688:
679:
676:
639:cardiomyopathy
620:Main article:
617:
614:
606:
605:
598:
595:
585:
571:
564:
552:
551:
548:
545:
542:
538:
537:
534:
531:
528:
524:
523:
520:
517:
514:
510:
509:
506:
503:
500:
496:
495:
492:
489:
486:
436:
433:
401:
398:
360:in isolation.
338:pulse pressure
305:may be due to
268:cardiac arrest
256:fast breathing
231:
230:
227:
223:
222:
219:
213:
212:
203:
197:
196:
193:
189:
188:
181:
175:
174:
121:
117:
116:
99:
95:
94:
92:cardiac arrest
76:
70:
69:
64:
58:
57:
43:
42:
34:
33:
25:
15:
9:
6:
4:
3:
2:
5759:
5748:
5745:
5743:
5740:
5738:
5735:
5734:
5732:
5711:
5708:
5707:
5706:
5705:
5701:
5699:
5696:
5694:
5691:
5689:
5688:Caput medusae
5686:
5684:
5681:
5680:
5678:
5676:
5672:
5664:
5661:
5660:
5659:
5658:
5654:
5652:
5649:
5645:
5644:Lines of Zahn
5642:
5641:
5640:
5639:
5635:
5633:
5632:
5628:
5624:
5621:
5620:
5619:
5618:
5614:
5610:
5607:
5606:
5605:
5604:
5600:
5596:
5595:Oliver's sign
5593:
5591:
5588:
5587:
5586:
5585:
5581:
5580:
5578:
5576:
5572:
5569:
5567:
5563:
5553:
5550:
5546:
5543:
5542:
5541:
5540:
5536:
5534:
5531:
5529:
5526:
5524:
5522:
5518:
5517:
5515:
5511:
5505:
5502:
5500:
5497:
5495:
5491:
5487:
5486:
5484:
5482:
5478:
5472:
5469:
5467:
5463:
5460:
5458:
5455:
5453:
5449:
5448:
5446:
5444:
5439:
5433:
5430:
5428:
5425:
5423:
5422:MĂĽller's sign
5420:
5418:
5415:
5413:
5410:
5408:
5405:
5404:
5402:
5400:
5396:
5393:
5391:
5387:
5381:
5377:
5375:
5372:
5370:
5367:
5365:
5362:
5360:
5357:
5356:
5354:
5352:
5348:
5342:
5340:
5337:
5333:
5330:
5329:
5328:
5325:
5323:
5322:CĹ“ur en sabot
5320:
5316:
5313:
5312:
5311:
5308:
5307:
5305:
5301:
5295:
5292:
5288:
5285:
5283:
5280:
5279:
5278:
5275:
5273:
5270:
5268:
5265:
5263:
5260:
5259:
5257:
5255:
5251:
5243:
5240:
5239:
5238:
5235:
5233:
5230:
5228:
5225:
5219:
5216:
5215:
5214:
5213:
5209:
5207:
5204:
5202:
5199:
5195:
5192:
5190:
5187:
5186:
5185:
5182:
5178:
5175:
5173:
5170:
5169:
5168:
5165:
5164:
5163:
5160:
5156:
5155:Gallop rhythm
5153:
5151:
5148:
5146:
5143:
5141:
5138:
5137:
5136:
5133:
5132:
5130:
5128:
5124:
5116:
5115:Levine's sign
5113:
5112:
5111:
5108:
5106:
5105:Referred pain
5103:
5102:
5100:
5098:
5094:
5090:
5086:
5079:
5074:
5072:
5067:
5065:
5060:
5059:
5056:
5044:
5041:
5039:
5036:
5034:
5031:
5027:
5024:
5022:
5019:
5017:
5014:
5013:
5012:
5009:
5007:
5004:
5003:
5001:
4997:
4991:
4988:
4986:
4983:
4981:
4978:
4977:
4975:
4973:Organisations
4971:
4965:
4962:
4960:
4957:
4955:
4952:
4950:
4947:
4945:
4942:
4941:
4939:
4935:
4929:
4926:
4924:
4923:SAPS III
4921:
4919:
4916:
4914:
4911:
4909:
4906:
4904:
4901:
4900:
4898:
4896:
4892:
4886:
4883:
4880:
4877:
4875:
4872:
4870:
4867:
4865:
4862:
4860:
4857:
4855:
4852:
4850:
4847:
4845:
4842:
4840:
4837:
4836:
4834:
4830:
4824:
4821:
4817:
4814:
4812:
4809:
4808:
4806:
4804:
4801:
4799:
4796:
4794:
4791:
4789:
4786:
4782:
4779:
4777:
4774:
4773:
4771:
4767:
4764:
4763:
4762:
4758:
4755:
4754:
4752:
4750:
4746:
4740:
4737:
4735:
4732:
4728:
4725:
4723:
4720:
4718:
4717:Arterial line
4715:
4714:
4713:
4710:
4708:
4705:
4704:
4702:
4698:
4688:
4685:
4683:
4680:
4678:
4675:
4673:
4670:
4668:
4665:
4663:
4662:
4657:
4656:
4654:
4652:
4648:
4642:
4639:
4637:
4634:
4632:
4629:
4627:
4624:
4622:
4619:
4616:
4613:
4612:
4610:
4608:Complications
4606:
4600:
4597:
4595:
4592:
4590:
4587:
4586:
4583:
4580:
4578:
4575:
4573:
4570:
4568:
4565:
4563:
4560:
4558:
4557:Organ failure
4555:
4554:
4551:
4548:
4546:
4543:
4541:
4538:
4536:
4533:
4531:
4528:
4526:
4523:
4521:
4518:
4516:
4512:
4511:
4508:
4505:
4503:
4500:
4498:
4497:Severe sepsis
4495:
4493:
4490:
4488:
4485:
4482:
4481:
4479:
4475:
4472:
4468:
4462:
4459:
4457:
4454:
4451:
4448:
4445:
4442:
4439:
4436:
4433:
4430:
4429:
4427:
4425:General terms
4423:
4417:
4414:
4412:
4409:
4407:
4404:
4402:
4399:
4398:
4395:
4391:
4384:
4379:
4377:
4372:
4370:
4365:
4364:
4361:
4349:
4346:
4344:
4343:Cryptic shock
4341:
4339:
4336:
4334:
4331:
4330:
4328:
4324:
4316:
4315:Osmotic shock
4313:
4312:
4311:
4308:
4306:
4303:
4302:
4300:
4296:
4290:
4287:
4286:
4284:
4282:
4278:
4272:
4269:
4267:
4264:
4262:
4259:
4257:
4254:
4253:
4251:
4249:
4245:
4241:
4234:
4229:
4227:
4222:
4220:
4215:
4214:
4211:
4198:
4195:
4192:
4188:
4187:
4183:
4181:
4177:
4176:
4172:
4171:
4168:
4164:
4157:
4153:
4152:
4148:
4146:
4142:
4141:
4137:
4135:
4131:
4130:
4126:
4122:
4120:
4116:
4115:
4111:
4107:
4106:
4103:
4098:
4094:
4078:
4074:
4070:
4066:
4062:
4058:
4054:
4052:9780306390234
4048:
4044:
4040:
4036:
4032:
4028:
4024:
4020:
4019:
4011:
4003:
3999:
3995:
3991:
3987:
3986:Cannon, W. B.
3981:
3973:
3969:
3965:
3961:
3960:
3952:
3948:
3947:Cannon, W. B.
3942:
3934:
3930:
3926:
3922:
3921:
3913:
3906:
3900:
3895:
3891:
3888:
3884:
3883:
3878:
3872:
3864:
3860:
3856:
3852:
3847:
3842:
3839:(4): 234–49.
3838:
3834:
3830:
3823:
3815:
3814:
3806:
3798:
3794:
3788:
3784:
3783:
3775:
3773:
3764:
3760:
3755:
3750:
3746:
3742:
3738:
3734:
3730:
3723:
3715:
3711:
3707:
3703:
3698:
3693:
3689:
3685:
3681:
3674:
3666:
3662:
3658:
3654:
3650:
3646:
3641:
3636:
3632:
3628:
3624:
3617:
3609:
3605:
3601:
3597:
3593:
3589:
3586:(4): 379–83.
3585:
3581:
3574:
3572:
3563:
3559:
3554:
3549:
3545:
3541:
3537:
3533:
3529:
3522:
3520:
3511:
3507:
3503:
3499:
3495:
3491:
3488:(6): 542–47.
3487:
3483:
3476:
3468:
3464:
3459:
3454:
3450:
3446:
3442:
3438:
3434:
3427:
3419:
3415:
3410:
3405:
3401:
3397:
3393:
3389:
3385:
3381:
3377:
3370:
3362:
3358:
3354:
3350:
3346:
3342:
3338:
3334:
3326:
3318:
3314:
3310:
3306:
3302:
3298:
3291:
3289:
3287:
3278:
3272:
3268:
3261:
3253:
3249:
3244:
3239:
3235:
3231:
3227:
3220:
3212:
3208:
3203:
3198:
3194:
3190:
3186:
3182:
3178:
3171:
3163:
3157:
3153:
3149:
3142:
3134:
3130:
3126:
3122:
3118:
3114:
3110:
3106:
3099:
3091:
3087:
3082:
3077:
3072:
3067:
3063:
3059:
3058:
3053:
3046:
3038:
3034:
3030:
3026:
3023:(2): 300–18.
3022:
3018:
3014:
3007:
2999:
2995:
2991:
2987:
2983:
2979:
2975:
2968:
2960:
2956:
2949:
2941:
2935:
2931:
2924:
2910:
2906:
2900:
2898:
2889:
2885:
2880:
2875:
2870:
2865:
2861:
2857:
2856:Critical Care
2853:
2846:
2838:
2834:
2830:
2826:
2821:
2816:
2812:
2808:
2801:
2799:
2797:
2782:on 2015-09-24
2778:
2774:
2767:
2761:
2753:
2749:
2745:
2739:
2735:
2734:
2726:
2724:
2722:
2720:
2718:
2716:
2714:
2705:
2701:
2697:
2695:9780763789206
2691:
2687:
2680:
2672:
2668:
2664:
2660:
2656:
2652:
2651:
2646:
2642:
2635:
2627:
2623:
2619:
2615:
2611:
2607:
2602:
2597:
2594:(6): 951–62.
2593:
2589:
2585:
2577:
2569:
2565:
2561:
2557:
2553:
2549:
2545:
2541:
2538:(2): 154–62.
2537:
2533:
2529:
2522:
2514:
2510:
2506:
2502:
2498:
2494:
2490:
2486:
2483:(5): 403–19.
2482:
2479:(in German).
2478:
2474:
2467:
2459:
2455:
2450:
2445:
2440:
2435:
2431:
2427:
2424:(3): e57594.
2423:
2419:
2415:
2408:
2400:
2394:
2390:
2383:
2375:
2371:
2367:
2360:
2358:
2356:
2354:
2352:
2350:
2348:
2346:
2344:
2335:
2323:
2308:
2307:
2300:
2292:
2286:
2282:
2275:
2273:
2264:
2258:
2254:
2247:
2245:
2243:
2241:
2239:
2237:
2235:
2233:
2231:
2229:
2227:
2218:
2212:
2208:
2201:
2199:
2197:
2195:
2186:
2182:
2178:
2174:
2170:
2166:
2163:(3): 223–28.
2162:
2158:
2151:
2149:
2140:
2136:
2132:
2125:
2117:
2111:
2104:
2103:
2095:
2093:
2091:
2089:
2080:
2074:
2070:
2064:
2062:
2060:
2058:
2056:
2054:
2052:
2050:
2048:
2046:
2044:
2042:
2040:
2031:
2025:
2021:
2015:
2013:
2011:
2009:
2007:
2005:
2003:
2001:
1999:
1997:
1995:
1993:
1991:
1989:
1984:
1976:
1974:
1970:
1966:
1962:
1958:
1953:
1951:
1947:
1943:
1939:
1929:
1927:
1917:
1908:
1906:
1902:
1893:
1891:
1887:
1874:
1871:
1868:
1865:
1862:
1859:
1856:
1853:
1852:
1846:
1844:
1840:
1836:
1832:
1828:
1824:
1819:
1817:
1813:
1809:
1805:
1801:
1797:
1791:
1789:
1785:
1781:
1780:phenylephrine
1777:
1773:
1765:
1756:
1754:
1750:
1746:
1742:
1738:
1734:
1729:
1727:
1723:
1718:
1714:
1710:
1709:normal saline
1700:
1698:
1694:
1690:
1686:
1682:
1678:
1674:
1670:
1666:
1662:
1652:
1650:
1646:
1642:
1638:
1634:
1630:
1625:
1623:
1613:
1611:
1610:phosphorylate
1607:
1603:
1599:
1595:
1591:
1587:
1583:
1573:
1571:
1567:
1563:
1559:
1555:
1551:
1547:
1543:
1539:
1535:
1531:
1527:
1523:
1519:
1508:
1506:
1502:
1498:
1494:
1490:
1486:
1482:
1478:
1474:
1470:
1466:
1462:
1458:
1454:
1450:
1446:
1442:
1438:
1434:
1430:
1429:baroreceptors
1426:
1414:
1410:
1399:
1397:
1393:
1389:
1385:
1381:
1377:
1373:
1369:
1365:
1364:hypoperfusion
1355:
1352:
1349:condition of
1348:
1343:
1340:
1335:
1327:
1318:
1316:
1312:
1308:
1304:
1300:
1296:
1292:
1282:
1280:Distributive
1279:
1278:
1274:
1271:
1270:
1266:
1263:
1262:
1258:
1255:
1254:
1250:
1247:
1246:
1235:
1231:
1227:
1223:
1219:
1215:
1211:
1207:
1204:
1200:
1196:
1193:
1190:
1186:
1182:
1178:
1175:
1174:
1173:
1162:
1158:
1154:
1150:
1146:
1142:
1137:
1133:
1129:
1125:
1122:
1118:
1114:
1111:
1108:
1105:Wheezing and
1104:
1101:
1097:
1096:
1090:
1085:
1081:
1077:
1073:
1069:
1065:
1061:
1058:
1052:
1049:
1047:
1044:
1041:
1039:
1035:
1032:
1031:
1029:
1026:
1022:
1018:
1017:
1016:
1012:
1008:
1004:
1000:
996:
992:
987:
983:
979:
975:
971:
967:
966:Gram-positive
963:
959:
958:
953:
949:
948:
943:
942:Gram negative
939:
935:
932:
931:
929:
924:
922:
918:
914:
910:
906:
898:
894:
892:
889:
888:
884:
880:
878:
875:
874:
870:
868:
865:
864:
860:
858:
855:
854:
850:
847:
846:
843:
837:
824:
821:
818:
815:
812:
808:
805:
804:
803:
797:
793:
790:
787:
783:
780:
778:
774:
771:
768:
764:
761:
758:
755:
752:
748:
745:
742:
738:
735:
734:
733:
731:
730:great vessels
727:
722:
710:
706:
703:
701:
698:
696:
692:
689:
687:
683:
680:
677:
675:
671:
670:jugular veins
667:
666:
665:
663:
658:
656:
652:
648:
644:
640:
636:
632:
628:
623:
613:
611:
603:
599:
596:
593:
589:
586:
584:
580:
576:
572:
569:
565:
563:
559:
558:
557:
549:
546:
543:
540:
539:
535:
532:
529:
526:
525:
521:
518:
515:
512:
511:
507:
504:
501:
498:
497:
493:
490:
487:
484:
483:
477:
475:
471:
467:
463:
459:
455:
451:
446:
442:
432:
430:
426:
422:
417:
415:
411:
407:
397:
394:
390:
386:
382:
378:
374:
370:
366:
361:
359:
355:
351:
347:
343:
339:
335:
330:
328:
325:, or certain
324:
320:
316:
312:
308:
304:
300:
296:
292:
288:
284:
280:
276:
271:
269:
265:
261:
257:
253:
249:
245:
241:
237:
228:
224:
220:
218:
214:
211:
207:
204:
202:
198:
194:
190:
186:
185:physical exam
182:
180:
176:
173:
169:
165:
161:
157:
153:
149:
145:
141:
140:heart failure
137:
133:
129:
125:
122:
118:
115:
111:
107:
103:
100:
96:
93:
89:
86:: Confusion,
85:
80:
77:
75:
71:
68:
65:
63:
59:
55:
51:
48:
44:
40:
35:
30:
22:
5702:
5655:
5651:Adson's sign
5636:
5629:
5623:Allen's test
5615:
5601:
5582:
5537:
5533:Aschoff body
5519:
5504:Ewart's sign
5499:Beck's triad
5488:
5466:Osler's node
5452:endocarditis
5450:
5432:Mayne's sign
5378:See further
5374:Distributive
5350:
5310:Palpitations
5276:
5210:
5162:Heart murmur
5135:Heart sounds
5127:Auscultation
5043:Traumatology
4944:Hemodynamics
4918:SAPS II
4885:Vasopressors
4803:Induced coma
4660:
4651:Iatrogenesis
4641:Stress ulcer
4545:Spinal shock
4514:
4502:Septic shock
4338:Spinal shock
4256:Septic shock
4248:Distributive
4239:
4184:
4173:
4149:
4138:
4123:
4108:
4017:
4010:
4001:
3997:
3980:
3963:
3957:
3941:
3924:
3918:
3905:
3881:
3871:
3836:
3832:
3822:
3812:
3805:
3797:the original
3781:
3736:
3732:
3722:
3687:
3683:
3673:
3630:
3626:
3616:
3583:
3579:
3535:
3531:
3485:
3481:
3475:
3440:
3436:
3426:
3383:
3379:
3369:
3336:
3332:
3325:
3317:the original
3304:
3300:
3266:
3260:
3233:
3229:
3219:
3184:
3180:
3170:
3147:
3141:
3108:
3104:
3098:
3061:
3055:
3045:
3020:
3016:
3006:
2981:
2977:
2967:
2958:
2954:
2948:
2929:
2923:
2912:. Retrieved
2908:
2859:
2855:
2845:
2810:
2806:
2784:. Retrieved
2777:the original
2772:
2760:
2732:
2685:
2679:
2654:
2648:
2634:
2591:
2587:
2576:
2535:
2531:
2521:
2480:
2476:
2466:
2421:
2417:
2407:
2388:
2382:
2373:
2369:
2311:. Retrieved
2305:
2299:
2280:
2252:
2206:
2160:
2156:
2130:
2124:
2101:
2068:
2019:
1973:vasodilation
1968:
1954:
1941:
1935:
1926:Septic shock
1922:
1901:Septic shock
1899:
1896:Epidemiology
1883:
1820:
1812:septic shock
1792:
1772:Vasopressors
1770:
1730:
1717:crystalloids
1706:
1661:septic shock
1658:
1626:
1619:
1602:vasodilation
1586:Brain damage
1579:
1514:
1405:
1402:Compensatory
1361:
1344:
1336:
1332:
1311:septic shock
1305:is known as
1293:is known as
1288:
1272:Obstructive
1264:Cardiogenic
1171:
1157:spinal shock
989:limited to:
974:streptococci
955:
945:
938:vasodilation
934:Septic shock
928:Septic shock
913:septic shock
903:
830:Distributive
801:
724:
660:Symptoms of
659:
635:dysrhythmias
625:
607:
555:
448:
427:, prolonged
418:
410:urine output
408:, decreased
403:
393:Vasopressors
373:embolization
362:
331:
295:heart attack
272:
235:
234:
210:vasopressors
160:Distributive
159:
147:
136:heart attack
131:
128:pancreatitis
123:
114:distributive
83:
78:
5481:Pericardium
5457:Roth's spot
5443:endocardium
5369:Hypovolemic
5364:Obstructive
5359:Cardiogenic
5267:Bradycardia
5262:Tachycardia
5232:Heart click
5026:Pulmonology
4949:Hypotension
4844:Antibiotics
4687:Dialytrauma
4530:Anaphylaxis
4333:Cardiogenic
4310:Hypovolemia
4281:Obstructive
4175:MedlinePlus
2984:(4): A401.
1957:World War I
1938:Hippocrates
1823:epinephrine
1759:Medications
1733:hypotension
1697:hypothermia
1649:chest X-ray
1645:lactic acid
1538:capillaries
1505:homeostatic
1457:epinephrine
1441:epinephrine
1437:hypotension
1435:detect the
1384:Krebs cycle
1351:homeostatic
1299:dehydration
1256:Low volume
1189:hypotension
1161:spinal cord
1015:neutrophils
970:pneumococci
917:anaphylaxis
871:>90/min
857:Temperature
751:pericardium
741:pericardium
715:Obstructive
693:in case of
643:myocarditis
616:Cardiogenic
610:shock index
588:Hypothermia
562:tachycardia
441:Hypovolemia
425:skin turgor
350:shock index
319:anaphylaxis
283:obstructive
279:cardiogenic
275:hypovolemic
148:Obstructive
132:Cardiogenic
110:obstructive
106:cardiogenic
5731:Categories
5339:Hyperaemia
5201:Continuous
5097:Chest pain
5033:Pediatrics
5016:Cardiology
4937:Physiology
4839:Analgesics
4788:Chest tube
4617:/ myopathy
4594:Polytrauma
4470:Conditions
4305:Hemorrhage
4298:Low-volume
4151:DiseasesDB
3966:(3): 174.
3920:The Lancet
3064:(1): 177.
2914:2019-02-22
2862:(4): 221.
2786:2015-03-25
2313:2019-05-09
1979:References
1839:ranitidine
1829:, such as
1788:dobutamine
1726:hemoglobin
1665:intubation
1655:Management
1612:into ATP.
1576:Refractory
1534:sphincters
1461:heart rate
1455:, whereas
1453:heart rate
1303:blood loss
1221:condition.
1036:, often a
867:Heart rate
809:, often a
684:, often a
668:Distended
657:problems.
573:Rapid and
494:Treatment
458:hemorrhage
435:Low volume
423:, reduced
414:β-blockers
379:, such as
240:blood flow
201:Medication
170:, certain
124:Low volume
102:Low volume
5315:Apex beat
5184:Diastolic
5021:Neurology
4874:Sedatives
4854:Inotropes
4700:Diagnosis
4197:emerg/533
4191:emerg/531
4186:eMedicine
4061:0065-2598
4043:2214-8019
3855:0007-0912
3649:0028-4793
3400:1469-493X
3029:1063-7389
2998:0012-3692
2815:CiteSeerX
2704:785442005
2610:0342-4642
2552:1531-7072
2497:0003-2417
2332:ignored (
2322:cite book
1955:Prior to
1911:Prognosis
1843:Albuterol
1749:mentation
1616:Diagnosis
1606:uric acid
1594:adenosine
1558:viscosity
1546:histamine
1522:potassium
1382:into the
1224:Relative
1168:Endocrine
1132:headaches
1128:confusion
1080:histamine
1021:histamine
999:leukocyte
995:inotropic
962:endotoxin
954:species,
707:, due to
695:tamponade
664:include:
592:perfusion
369:breathing
327:overdoses
226:Frequency
217:Prognosis
192:Treatment
172:overdoses
134:: severe
62:Specialty
5638:thrombus
5575:Arterial
5167:Systolic
5140:Split S2
4712:Catheter
4631:Fungemia
4406:Medicine
4069:72077225
3992:(1919).
3894:99000784
3879:(1899).
3763:25392034
3706:24171518
3657:24171518
3608:22613993
3600:18614899
3562:23235609
3510:19918811
3502:19713836
3467:26878401
3418:26878401
3361:39310937
3353:28930937
3313:22164397
3252:30852043
3211:30073665
3133:45691590
3125:24609389
3090:30340602
2909:UpToDate
2888:16879732
2837:17826209
2752:69672074
2626:10770608
2618:17377769
2568:42407737
2560:19276799
2513:39461027
2505:25994928
2458:23483915
2418:PLOS ONE
2185:19881753
2177:24712642
2139:29261964
2106:(E-book)
1831:Benadryl
1784:dopamine
1713:Colloids
1566:ischemic
1465:vascular
1433:arteries
1409:acidosis
1380:pyruvate
1121:vomiting
1117:diarrhea
1068:allergen
583:acidosis
508:minimal
491:Response
466:diarrhea
462:vomiting
291:diarrhea
260:sweating
74:Symptoms
5277:doubled
5242:carotid
5038:Surgery
4194:med/285
4145:D012769
3899:Alt URL
3863:5328405
3754:4239778
3714:6900105
3665:6900105
3553:6464614
3458:6516856
3409:6516856
3202:6513027
3081:6194579
3037:8774804
2879:1750971
2671:1303622
2449:3590203
2426:Bibcode
1932:History
1554:protein
1485:kidneys
1431:in the
1368:hypoxia
1366:causes
1358:Initial
1347:runaway
1072:antigen
952:Proteus
848:Finding
649:(CHF),
577:due to
244:tissues
242:to the
79:Initial
47:US Navy
5675:Venous
5545:J wave
5441:Other
5110:Angina
4513:Other
4492:Sepsis
4446:(PICU)
4440:(NICU)
4180:000039
4134:785.50
4077:549969
4075:
4067:
4059:
4049:
4041:
3892:
3861:
3853:
3789:
3761:
3751:
3712:
3704:
3663:
3655:
3647:
3606:
3598:
3560:
3550:
3508:
3500:
3465:
3455:
3416:
3406:
3398:
3359:
3351:
3311:
3273:
3250:
3209:
3199:
3158:
3131:
3123:
3088:
3078:
3035:
3027:
2996:
2936:
2886:
2876:
2835:
2817:
2750:
2740:
2702:
2692:
2669:
2624:
2616:
2608:
2566:
2558:
2550:
2511:
2503:
2495:
2456:
2446:
2395:
2287:
2259:
2213:
2183:
2175:
2137:
2112:
2075:
2026:
1942:exemia
1800:trauma
1786:, and
1703:Fluids
1518:sodium
1471:. The
1251:Cause
1208:Acute
1119:, and
1066:to an
851:Value
796:sepsis
454:volume
365:airway
344:minus
315:sepsis
285:, and
164:Sepsis
120:Causes
5513:Other
5351:Shock
5303:Other
5254:Pulse
5237:Bruit
4881:drugs
4832:Drugs
4515:shock
4452:(CCU)
4434:(ICU)
4326:Other
4240:Shock
4156:12013
4039:eISSN
3954:(PDF)
3915:(PDF)
3710:S2CID
3661:S2CID
3604:S2CID
3506:S2CID
3357:S2CID
3129:S2CID
2978:Chest
2955:Shock
2780:(PDF)
2769:(PDF)
2650:Chest
2622:S2CID
2564:S2CID
2509:S2CID
2376:(10).
2181:S2CID
1869:(TAH)
1837:) or
1798:from
1679:(not
1501:urine
1497:brain
1493:lungs
1481:renal
1419:). CO
1248:Type
1241:Cause
1100:hives
897:bands
883:PaCO2
767:lungs
653:, or
485:Class
356:or a
309:or a
266:, or
236:Shock
98:Types
84:Later
32:Shock
4928:SOFA
4913:PIM2
4759:and
4599:Coma
4487:SIRS
4140:MeSH
4129:9-CM
4073:OCLC
4065:LCCN
4057:ISSN
4047:ISBN
3890:LCCN
3859:PMID
3851:ISSN
3787:ISBN
3759:PMID
3702:PMID
3653:PMID
3645:ISSN
3596:PMID
3558:PMID
3536:2018
3498:PMID
3463:PMID
3414:PMID
3396:ISSN
3349:PMID
3309:PMID
3271:ISBN
3248:PMID
3207:PMID
3156:ISBN
3121:PMID
3086:PMID
3033:PMID
3025:ISSN
2994:ISSN
2934:ISBN
2884:PMID
2833:PMID
2748:OCLC
2738:ISBN
2700:OCLC
2690:ISBN
2667:PMID
2614:PMID
2606:ISSN
2556:PMID
2548:ISSN
2501:PMID
2493:ISSN
2454:PMID
2393:ISBN
2334:help
2285:ISBN
2257:ISBN
2211:ISBN
2173:PMID
2135:PMID
2110:ISBN
2073:ISBN
2024:ISBN
1715:and
1552:and
1495:and
1443:and
1076:drug
1025:SIRS
986:SCCM
982:ACCP
972:and
472:and
464:and
443:and
419:Dry
5539:EKG
4125:ICD
4119:R57
4110:ICD
4031:doi
3968:doi
3929:doi
3925:166
3841:doi
3749:PMC
3741:doi
3692:doi
3688:369
3635:doi
3631:369
3588:doi
3548:PMC
3540:doi
3490:doi
3453:PMC
3445:doi
3404:PMC
3388:doi
3341:doi
3337:125
3238:doi
3197:PMC
3189:doi
3113:doi
3109:348
3105:BMJ
3076:PMC
3066:doi
2986:doi
2982:152
2874:PMC
2864:doi
2825:doi
2659:doi
2655:101
2596:doi
2540:doi
2485:doi
2444:PMC
2434:doi
2165:doi
1590:ATP
1390:by
1301:or
923:).
891:WBC
527:III
383:or
297:or
50:EMT
5733::
5150:S4
5145:S3
4189::
4178::
4154::
4143::
4132::
4117::
4114:10
4071:.
4063:.
4055:.
4045:.
4037:.
4029:.
4002:26
4000:.
3996:.
3988:;
3964:73
3962:.
3956:.
3923:.
3917:.
3857:.
3849:.
3837:38
3835:.
3831:.
3771:^
3757:.
3747:.
3737:40
3735:.
3731:.
3708:.
3700:.
3686:.
3682:.
3659:.
3651:.
3643:.
3629:.
3625:.
3602:.
3594:.
3584:14
3582:.
3570:^
3556:.
3546:.
3534:.
3530:.
3518:^
3504:.
3496:.
3486:15
3484:.
3461:.
3451:.
3439:.
3435:.
3412:.
3402:.
3394:.
3382:.
3378:.
3355:.
3347:.
3335:.
3305:13
3303:.
3299:.
3285:^
3246:.
3234:37
3232:.
3228:.
3205:.
3195:.
3183:.
3179:.
3150:.
3127:.
3119:.
3107:.
3084:.
3074:.
3062:15
3060:.
3054:.
3031:.
3019:.
3015:.
2992:.
2980:.
2976:.
2907:.
2896:^
2882:.
2872:.
2860:10
2858:.
2854:.
2831:.
2823:.
2811:25
2809:.
2795:^
2771:.
2746:.
2712:^
2698:.
2665:.
2653:.
2620:.
2612:.
2604:.
2592:33
2590:.
2586:.
2562:.
2554:.
2546:.
2536:15
2534:.
2530:.
2507:.
2499:.
2491:.
2481:64
2475:.
2452:.
2442:.
2432:.
2420:.
2416:.
2372:.
2368:.
2342:^
2326::
2324:}}
2320:{{
2271:^
2225:^
2193:^
2179:.
2171:.
2161:26
2159:.
2147:^
2133:.
2087:^
2038:^
1987:^
1825:.
1806:.
1790:.
1782:,
1778:,
1675:,
1671:,
1572:.
1487:,
1398:.
1134:,
1130:,
1115:,
1086:.
1074:,
1070:,
950:,
645:,
637:,
541:IV
513:II
476:.
375:.
329:.
321:,
317:,
301:.
281:,
277:,
258:,
254:,
208:,
166:,
162::
154:,
150::
142:,
112:,
108:,
104:,
90:,
5523::
5496::
5492:/
5464:/
5454::
5077:e
5070:t
5063:v
4382:e
4375:t
4368:v
4232:e
4225:t
4218:v
4127:-
4112:-
4102:D
4079:.
4033::
3974:.
3970::
3935:.
3931::
3896:.
3865:.
3843::
3765:.
3743::
3716:.
3694::
3667:.
3637::
3610:.
3590::
3564:.
3542::
3512:.
3492::
3469:.
3447::
3441:2
3420:.
3390::
3384:2
3363:.
3343::
3279:.
3254:.
3240::
3213:.
3191::
3185:8
3164:.
3135:.
3115::
3092:.
3068::
3039:.
3021:4
3000:.
2988::
2942:.
2917:.
2890:.
2866::
2839:.
2827::
2789:.
2754:.
2706:.
2673:.
2661::
2643:/
2628:.
2598::
2570:.
2542::
2515:.
2487::
2460:.
2436::
2428::
2422:8
2401:.
2374:2
2336:)
2316:.
2293:.
2265:.
2219:.
2187:.
2167::
2141:.
2118:.
2081:.
2032:.
1833:(
1421:2
1417:2
1228:(
1212:(
1205:.
1197:(
1138:.
1123:.
1109:.
984:/
825:.
813:.
788:.
641:/
499:I
340:(
23:.
Text is available under the Creative Commons Attribution-ShareAlike License. Additional terms may apply.
_trainees_work_with_Naval_Station_Guantanamo_Bay_firemen_to.jpg)