Document Detail

Shock: a review of pathophysiology and management. Part II.
MedLine Citation:
PMID:  16597286     Owner:  NLM     Status:  PubMed-not-MEDLINE    
OBJECTIVE: To review pathophysiology and management of hypovolaemic, cardiogenic and septic shock in a two part presentation. DATA SOURCES: Articles and published peer-review abstracts and a review of studies reported from 1994 to 1998 and identified through a MEDLINE search of the English language literature on septic shock, cardiogenic shock and hypovolaemic shock. SUMMARY OF REVIEW: The pathophysiological effects of cardiogenic and hypovolaemic shock are related predominantly to a reduction in preload and myocardial contractility, respectively, whereas the pathophysiological effects of septic shock result largely from the overwhelming production of inflammatory mediators. The excessive inflammatory response results in haemodynamic compromise and widespread tissue injury. While the understanding of the acute inflammatory reaction has improved, therapies to modulate the chemical mediators responsible for the organ dysfunction associated with this reaction have not altered mortality, and in some instances may have increased it. Treatment of septic shock is still largely supportive, using intravenous fluids and inotropic agents to provide adequate tissue perfusion while the infective lesion is managed with antibiotic therapy and surgical drainage of septic focus. CONCLUSIONS: Septic shock is provoked by an excessive acute inflammatory response to an infection. Management of the shock is supportive using fluids and inotropic agents, while antibiotic therapy and surgical drainage of the septic focus take effect. Immunomodulation of the acute inflammatory response causing septic shock has not improved mortality.
L I Worthley
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Critical care and resuscitation : journal of the Australasian Academy of Critical Care Medicine     Volume:  2     ISSN:  1441-2772     ISO Abbreviation:  Crit Care Resusc     Publication Date:  2000 Mar 
Date Detail:
Created Date:  2006-04-06     Completed Date:  2006-04-20     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100888170     Medline TA:  Crit Care Resusc     Country:  Australia    
Other Details:
Languages:  eng     Pagination:  66-84     Citation Subset:  -    
Department of Critical Care Medicine, Flinders Medical Centre, Adelaide, South Australia.
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Comment In:
Crit Care Resusc. 2000 Mar;2(1):8-9   [PMID:  16597275 ]

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