ABSTRACT
Shock is a term used to broadly categorize a group of physiologic states, which, if left untreated, ultimately result in cardiovascular failure and death. Credit for the earliest use of this term goes to the French surgeon, Le Dran, in 1737. In his manuscript ‘‘A Treatise of Reflections Drawn from Experience with Gunshot Wounds,’’ the word ‘‘choc’’ was used to describe a severe jolt or impact (1). Over a century later, Gross eloquently described shock as ‘‘a rude unhinging of the machinery of life’’ (2), a sentiment shared by many who followed him, frustrated at the difficulty of resuscitating a patient from severe shock. At the end of the 19th century, shock was referred to as ‘‘a momentary pause in the act of death’’ by Warren (3). At approximately the same time, Crile noted a decrease in central venous pressure in response to hemorrhage, as well as a survival benefit associated with saline resuscitation (4). Blalock, in one of the first ‘‘modern’’ descriptions, defined shock as ‘‘peripheral circulatory failure, from a discrepancy between the size of the vascular bed and the volume of intravascular fluid’’ (5). Blalock’s description of shock has served as a starting point toward our current understanding of shock, which is characterized by the presence of inadequate tissue perfusion and oxygenation.
