Introduction 1. 1731. Le dran: french e first used shock te describe the severe condition of the patient of hurt
一、Introduction ： 1. 1731. Le Dran : French He first used ‘shock’ to describe the severe condition of the patient of hurt
2。1895 Warren describe the clinical manifestations of shock
2. 1895 Warren describe the clinical manifestations of shock
the face is pale or cyanosis cold and clammy skin rapid and thready pulse oliguria apath ★ hypotension( Crile)
• the face is pale or cyanosis • cold and clammy skin • rapid and thready pulse • oliguria • apathy ★hypotension (Crile)
Mechanism peripheral circulatory failure Vascular center- paralysis Treatment: pressor
Mechanism: peripheral circulatory failure Vascular center — paralysis Treatment: pressor
1960s The theory of microcirculation: Sympathetic adrenal medulla- hypersympathetic 7Os: Cellular metabolic disturbance 80s: septic shock
1960s: The theory of microcirculation: Sympatheticadrenal medulla — hypersympathetic 70s : Cellular metabolic disturbance 80s: septic shock
三、 Concept: Causes disturbance blood fow of microcirculation t functional and meta bolic disorders of the vital organs Inadequate tissue perfusion
二、Concept: Causes disturbance blood flow of microcirculation functional and metabolic disorders of the vital organs Inadequate tissue perfusion
三、 Etiology and classification of shock ( Etiology 1. Blood loss and body fluid loss SIHR/SBP SI Blood loss 0.5 10% compensation 1.0 20%30%shock 1.5 50% death
三、Etiology and classification of shock ㈠ Etiology 1. Blood loss and body fluid loss SI=HR/SBP SI Blood Loss 0.5 10% compensation 1.0 20% ~ 30% shock 1.5 50% death
fluid loss vomit. diarrhea collapse 2. Burn/trauma: pain, plasma loss burn shock, infection shock(late)
fluid loss vomit. diarrhea collapse 2.Burn/trauma: pain, plasma loss burn shock, infection shock(late)