Case II - ShockFatima Al Awadh
Shock is a state of organ hypoperfusion with
resultant cellular dysfunction and death.
This deprives the organs and tissues of
oxygen and allows the buildup of waste
products.
Symptoms include altered mental status,
tachycardia, hypotension, and oliguria.
4. What is the effect of this
kind of shock on the
kidneys, the heart, the
lungs, the brain and the
intestine?
Brain
LungsHeart
Intestine
Kidneys
Low BP
Hypothalamus
release
Aldosterone Release acts on
Water/and Sodium retention
Decreased Urine Output;
Raised Urea and Creatinine
activates activatesBaroreceptors
activates
Sympathetic Nervous Systemcauses
Vasoconstriction
causes
Decreased Renal Blood Flow causes
Renin Release Produces
Angiotensin II causes
ADH
acts on
Kidney Injuries
Acute Tubular Necrosis
Renal Insufficiency
Critical Renal Hypoperfusion
results in
Brain
LungsHeart
Intestine
Kidneys
Low BP
activates
Baroreceptorsactivates
Sympathetic Nervous Systemacts on
Raised Heart Rate, myocardial contractility, and vasoconstriction
Tachycardia; weak thready pulse
Coronary Hypoperfusion
acts on
Decreased Cardiac Outputinitiating
Depress Contractility, and Worsen Myocardial Complianceresults in
A Vicious Cycle- Further Hypoperfusion
Brain
LungsHeart
Intestine
Kidneys
Low pH
activates
Chemoreceptorsactivates
Respiratory Centeracts on
Raised Respiration Rate and Depth
(why?)
Increased Membrane Permeability
leads to
Flooding of Alveolistimulates
Further Inflammationacts on
Resistant Hypoxia Acute Lung Injury; or
Acute Respiratory Distress Syndrome
Brain
LungsHeart
Intestine
Kidneys
Low pH
causes
Restlessness (early)
Coma (late)
Neuronal Depression
leading to
Cerebral Hypoperfusion
Inhibation of metabolism and cell volume regulation
stimulates
leading to
Brain
LungsHeart
Intestine
Kidneys
Low BP activates
Baroreceptorsactivates
Sympathetic Nervous Systemcauses
Vasoconstriction
causes
Decreased Blood Flow
acts on
leading to Decreased Motility
and Permeability
causes
Ileus and Submucosal Hemorrhage
Decreased Motility
and Permeability
The human body responds to acute
hemorrhage by activating some major
physiologic systems resulting in
changes in kidneys, heart, lungs, brain,
and intestine.
“Thank
You”