cardio - dg26

[ArchivalUser]

can any1 plz help wid the different types of shocks
1.cardiogenic
2,neurogenic
3.septic shock

[ArchivalUser]

seniors okt3, toha, algeria, thrombo, plz correct wherever wrong:

cardiogenic: because of pump failure of the heart, eg cardiac arrest
PCWP: increased
MVO2 (mixed venous O2 content): decreased

neurogenic: loss of symp motor tine to blood vessels--> dilation--> dec peripheral resistance-> drop in BP
PCWP: ??low
MVO2: decreased

septic shock: due to release of endotoxin--> incr vascular permeability/inapropriate vasodilation
PCWP: low
MVO2: normal

[ArchivalUser]

ok Sam i start with septic shock please, please wait for the correction of senior members:

in septic shock you have two phases Hyperdynamic and hypodynamic state

*Hyperdynamic : decrease TPR, decreased RAP, increase Coutput, warm extermities. ( may remain till 6-72 hours) before the onset of hypodynamic state.PCWP normal/ decreased MVO2 increased.

*Hypodynamic: decrease Coutput, increase TPR, increase RAP. cold extermities.PCWP normal or increased.


Cardiogenic shock: Coutput decreased, TPR increased, RAP and CVP increased; PCWP increased. MVO2 decreased. skin cold and clammy.

neurogenic shock:decrease TPR decrease CO, decrease RAP/CVP, decrease/normal PCWP, decrease MVO2
warm pink extremities.

hypovolemic decrease all parameters except TPR. skin pale, cool.

Hope that helps and please wait for the correction of senior members, where are you OKT3 thrombolyser guest Mos toha?????

[ArchivalUser]

and seniors plz explain the differences in MVO2 in these 3 scenarios. appreciate ur help very much.

[ArchivalUser]

Sam it is very simple i think that MVO2 is related to cardiac output, when cardiac output increase Oxygen extraction increase too (ie hyperdynamic state of septic shock), all the other shock you ll have decrease MVO2.

[ArchivalUser]

i remember UW saying that in septic shock it was due to maldistribution or something..it wasnt very clear..

[ArchivalUser]

Sam the problem with septic shock is that you may have 2 phases ( hyperdynamic states with increase Contractility and Cardiac output) >>>> increase MVO2
and hypodynamic states with Decrease cardiac output >>> Decrease MVO2.

[ArchivalUser]

thankyou algeria92

[ArchivalUser]

thankx every1