ABSTRACT
This chapter provides an overview of the effects of shock, symptoms and main treatments. There are four types of shock: cardiogenic, obstructive, hypovolaemic, and distributive. Shock is often classified into four stages, reflecting its progression and homeostatic responses: initial, compensation, progression, and refractory. Perfusion may fail due to: insufficient circulating volume, inadequate cardiac output, and excessive peripheral vasodilatation. Metabolic acidosis, from systemic hypoperfusion, stimulates a compensatory respiratory alkalosis. Complex pathologies cause imbalance and failure of compensatory and autoregulation mechanisms. The most frequent cause of distributive shock seen in intensive care unit is sepsis. Other types of distributive shock include: neurogenic, spinal, anaphylaxis, and toxic shock syndrome. If other therapies fail, intra-aortic balloon pumps, ventricular assist devices and extracorporeal membrane oxygenators can support perfusion with life-threatening heart failure, "buying time" for interventions such as transplantation percutaneous coronary intervention/surgery or spontaneous recovery.
