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”