Scribd Logo
Upload

Welcome to Scribd!

  • 84 views

    Distributive Shock 1

    Uploaded by

    Fuzi Hanny
    1. Distributive shock results from widespread systemic allergic reaction to an antigen and is life-threatening. 2. Early recognition and aggressive treatment with airway support, epinephrine, antihistamines, corticosteroids, and immediate withdrawal of the antigen if possible are crucial to management. 3. Septic shock is a form of distributive shock caused by systemic infection leading to organ dysfunction. Goals of therapy are to treat the underlying infection, support oxygen delivery, provide nutrition, and promote tissue perfusion and comfort measures.

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd

    Distributive Shock 1

    Uploaded by

    Fuzi Hanny
    84 views41 pages
    1. Distributive shock results from widespread systemic allergic reaction to an antigen and is life-threatening. 2. Early recognition and aggressive treatment with airway support, epinephrine, antihistamines, corticosteroids, and immediate withdrawal of the antigen if possible are crucial to management. 3. Septic shock is a form of distributive shock caused by systemic infection leading to organ dysfunction. Goals of therapy are to treat the underlying infection, support oxygen delivery, provide nutrition, and promote tissue perfusion and comfort measures.

    Original Description:

    distributive shock

    Copyright

    © © All Rights Reserved

    Available Formats

    PPT, PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    1. Distributive shock results from widespread systemic allergic reaction to an antigen and is life-threatening. 2. Early recognition and aggressive treatment with airway support, epinephrine, antihistamines, corticosteroids, and immediate withdrawal of the antigen if possible are crucial to management. 3. Septic shock is a form of distributive shock caused by systemic infection leading to organ dysfunction. Goals of therapy are to treat the underlying infection, support oxygen delivery, provide nutrition, and promote tissue perfusion and comfort measures.

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    84 views41 pages

    Distributive Shock 1

    Uploaded by

    Fuzi Hanny
    1. Distributive shock results from widespread systemic allergic reaction to an antigen and is life-threatening. 2. Early recognition and aggressive treatment with airway support, epinephrine, antihistamines, corticosteroids, and immediate withdrawal of the antigen if possible are crucial to management. 3. Septic shock is a form of distributive shock caused by systemic infection leading to organ dysfunction. Goals of therapy are to treat the underlying infection, support oxygen delivery, provide nutrition, and promote tissue perfusion and comfort measures.

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    of 41

    DISTRIBUTIVE SHOCK

    Dr. WIGNYO SANTOSA, SpAn, KIC, FIPM


    Anesthesiology Department
    Medical Faculty of Unissula
    SHOCK
    • Sindrom klinis akibat kegagalan
    sirkulasi dalam memenuhi
    kebutuhan oksigen jaringan tubuh

    ATAU

    • Inadekuat perfusi jaringan &


    hipofungsi sel
    Pathophysiology of shock

    Impaired tissue perfusion occurs when


    an imbalance develops between
    cellular oxygen supply and cellular
    oxygen demand.

    All Types of shock eventually result in


    impaired tissue perfusion & the development
    of acute circulatory failure or shock
    syndrome.
    PATHOPHYSIOLOGY
    SHOCK

    Perfusi jaringan terganggu

    Disfungsi sel

    KEMATIAN SEL
    Macam-macam Shock
    • Shock hipovolemik
    • Shock distributif
    • Shock obstruktif
    • Shock kardiogenik
    Tahapan Syok
    • Tahap awal/kompensasi
    – MAP turun 10-15 mmHg
    – Aktivasi simpatis vs. parasimpatis
    • Ditandai oleh vasokonstriksi selektif: ginjal, otot, kulit dan
    splanknik  menperbaiki sirkulasi otak dan jantung
    – Penurunan aliran darah koroner  metabolisme anaerob &
    dilatasi arteri
    – Ginjal  pelepasan hormon
    • Epinefrin, norepinefrin
    • Glikokortikoid
    • Renin – angiotensin – aldosteron
    – Pituitari anterior: sekresi ADH

     Pe↑ produksi energi


     Pe↑ volume sirkulasi Peningkatan
     Pe↑ kontraktilitas CO
    Tahapan Syok
    • Tahap lanjut/intermediate/progresif
    – MAP turun > 20 mmHg
    – Bila kompensasi awal gagal:
    • Vasokonstriksi berlanjut dengan pe↓ MAP  perfusi
    jaringan tidak adekuat & hipoksia
    – Metabolisme anaerob sistemik  produksi asam
    laktat  asidosis metabolik
    – Pe↓ produksi ATP  ggn transpor membran 
    edema sel, ruptur sel
    – Respon renal berlanjut
    – Perburukan fungsi jantung

    Penurunan CO
    Tahapan Syok
    • Tahap Irreversible
    – Kompensasi tidak mampu mempertahankan
    perfusi otak & jantung
    – Depresi fungsi miokard berlanjut
    – Iskemia otak  depresi fungsi neuron 
    kehilangan mekanisme kompensasi neuronal
    sentral
    – Vasokonstriksi mikrosirkulasi  pe↓
    venous return
    Kompensasi tubuh

    1. Takikardi

    2. Vasokonstriksi
    ↓ Cardiac output

    3. Tekanan Nadi
    turun
    ↓ aliran darah
    A type of distributive shock that
    results from widespread systemic
    allergic reaction to an antigen

     This
    hypersensitive reaction is
    LIFE THREATENING
     Early Recognition, treat aggressively
     AIRWAY SUPPORT
     IV EPINEPHRINE (open

     Antihistamines

     Corticosteroids

     IMMEDIATE WITHDRAWAL OF ANTIGEN


    IF POSSIBLE
     PREVENTION
     Judicious crystalloid administration
     Vasopressors to maintain organ
    perfusion
     Positive inotropes

     Patient education
    Pathophysiology of Neurogenic Shock
    MEDICAL
    MANAGEMENT
     Goals of Therapy are
    to treat or remove the
    cause & prevent
    cardiovascular
    instability, & promote
    optimal tissue
    perfusion
    SEPSIS
    SEPSIS WITH:
    Microorganisms enter body

    Mediator Release

    Activation of Complement, kallikrein / kinin/ coagulation
    & fibrinolytic factors platelets, neutrophils &
    macrophages>>damage to endothelial cells.
    ORGAN DYSFUNCTION
    Clinical Manifestations
     Late hypodynamic state

    Decrease UOP
    Decrease CO
    Metabolic &
    respiratory acidosis
    with hypoxemia
    MANAGEMENT

     Maximize O2
    delivery Support
     Nutritional Support
     Comfort &
    Emotional support
    Sequelae of Septic Shock

    The effects of the bacteria’s endotoxins


    can continue even after the bacteria is
    dead!!!
    Sepsis
    400,000 7-17%

    Severe Sepsis 20-53%


    300,000

    Septic
    53-63%
    Shock

    You might also like