China
Africa
Explore chapters and articles related to this topic
Emergency Preparedness and Response
Published in Neil McManus, Safety and Health in Confined Spaces, 2018
The term “shock” describes several conditions having different origins. “Hypovolemic shock” refers to the condition caused by loss of blood through bleeding or loss of fluid through burns. “Cardiogenic shock” results from damage to the heart caused by heart attack or direct traumatic injury. “Anaphylactic shock,” “bacteremic (septic) shock,” and “neurogenic (spinal) shock” result in excessive dilation of blood vessels. The normal volume of blood is insufficient to fill dilated blood vessels. Anaphylactic shock results from severe allergic reaction. Agents that cause anaphy-lactic shock include insect stings, antibiotics, seafood, and nuts, as well as other agents. Bacteremic shock results from the action of bacterial toxins on blood vessels. Neurogenic shock occurs in rare cases following a spinal injury that causes complete paralysis.
Clinical Workflows Supported by Patient Care Device Data
Published in John R. Zaleski, Clinical Surveillance, 2020
Shock can be caused by many things, but it is subdivided into four distinct groups: [117, 118] Hypovolemic shock: shock resulting from low blood volume as a result of blood loss or due to fluid loss (dehydration). The net result is hypoperfusion. Distributive shock: shock resulting from loss of blood vessel (i.e., smooth muscle) tone, causing hypoperfusion to result. Example causes can be anaphylaxis. Bacterial or viral infections can cause the body to respond by dilating blood vessels to facilitate white blood cell transport. The effect is hypoperfusion. Because of the systemic nature of the infection, however, the dilation becomes body wide. When blood vessels dilate, blood pressure goes down. Yet, the brain responds to the need for homeostasis and the heart rate increases in order to maintain cardiac output. This is why the shock index can be a good indicator of sepsis onset, as hypoperfusion is a chief indicator. Cardiogenic shock: shock induced when the heart fails in its ability to circulate blood adequately. This can occur as a result of myocardial infarction, causing injury to the heart muscle, or in cases of physical trauma. Hypoperfusion also results. Obstructive shock: blood is physically prevented from flowing. An example is pulmonary embolism. Blood is prevented from reaching essential organs, like portions of the lung, which results in hypoxia and necrosis.
Cardiac dysrhythmia management in the radiology department
Published in William H. Bush, Karl N. Krecke, Bernard F. King, Michael A. Bettmann, Radiology Life Support (Rad-LS), 2017
There are multiple risks associated with sustained VT. Even if the patient has a pulse and is hemodynamically stable, myocardial oxygen consumption is greatly increased and there is a risk of deterioration to ventricular fibrillation. If there is a pulse but insufficient cardiac output for tissue perfusion, cardiogenic shock will ensue. Pulseless VT is not of course a perfusing rhythm.
Mechanical circulatory support device selection for bridging to cardiac transplantation: a clinical guide
Published in Expert Review of Medical Devices, 2023
Tamari Miller, Veli K. Topkara
Cardiogenic shock is a state of systemic hypoperfusion due to primary cardiac dysfunction with grave morbidity and mortality rates. Two major etiologies of cardiogenic shock include acute coronary syndrome and decompensated acute on chronic heart failure. Life-threatening myocarditis can also be an indication for temporary mechanical circulatory support. Currently there is no standardized criteria for diagnosing cardiogenic shock. Clinical trials that study cardiogenic shock use varied criteria for inclusion and are based predominantly on cardiogenic shock complicating acute coronary syndrome (ACS). The Should We Emergently Revascularize Occluded Coronaries for Cardiogenic Shock (SHOCK) and Intra-aortic Balloon Pump in Cardiogenic Shock II (IABP-SHOCK II) trials proposed clinical and hemodynamic parameters for the diagnosis of cardiogenic shock [7,8]. Clinical criteria common to both trials included systolic blood pressure<90 mmHg for a period≥30 minutes and physical exam or biochemical evidence of end-organ hypoperfusion including cool extremities, urine output less than 30 cc/hour, altered mental status, and serum lactic acid greater than 2 mmol/L. Hemodynamic criteria, specifically used in the SHOCK trial, included reduced cardiac index (CI) less than 2.2Lmin−1m−2 and a pulmonary capillary wedge pressure (PCWP) greater than 15 mmHg. Patients whose hemodynamic profile and clinical status fail to improve with augmentation of cardiac output using inotropes should be considered for escalation to mechanical circulatory support to further augment cardiac output and improve hemodynamic profile and systemic perfusion. In refractory shock, when it is not possible to de-escalate from mechanical circulatory support, candidacy for heart transplant should be evaluated.
Overview of Impella and mechanical devices in cardiogenic shock
Published in Expert Review of Medical Devices, 2018
Hymie Habib Chera, Menachem Nagar, Nai-Lun Chang, Carlos Morales-Mangual, George Dous, Jonathan D. Marmur, Muhammad Ihsan, Paul Madaj, Yitzhak Rosen
Cardiogenic shock (CS) is a clinical condition of systemic hypotension with evidence of tissue hypoperfusion secondary to cardiac dysfunction with adequate or elevated filling pressures. The incidence of CS among patients aged ≥40 years with STEMI is 7.9%, with an increase in the proportion of STEMI patients developing CS from 6.5% in 2003 to 10.1% in 2010 [1]. The treatment options for CS include reperfusion therapy, vasopressors, inotropic agents, and mechanical circulatory support (MCS). All these treatment methods aim to improve the hemodynamics, cardiac output, and tissue perfusion.