Definition
Shock is an acute circulatory failure due to a critical reduction in the volume of blood circulating in the vascular system. More precisely, shock is a mismatch between the vascular capacity needed to keep all organs functioning and the filling of the vessels due to different causes. A heavy bleeding, but also a sudden dilatation of the vessels can be the cause of a shock.
The resulting reduced blood flow to the organs can lead to damage to the organs or even to organ failure. Especially tissues that depend on a good blood supply, such as for example: run the risk of suffering serious damage in a state of shock. To avoid this, blood centralizes in shock, which means that the body “collects” blood to ensure blood flow to the vital internal organs in the trunk. This also explains the pale skin color of the patient in the state of shock. Depending on the cause, a distinction is made between the:
- Brain
- Kidneys
- Heart and
- Lung
- Volume deficiency shock (hypovolemic) shock
- Cardiogenic shock (induced by the heart)
- The allergic (anaphylactic) shock
- The septic shock and
- Neurogenic shock (emanating from the nervous system).
General
The term shock describes a life-threatening condition of the body in which the blood circulation in the smallest vessels is reduced. This leads to an oxygen deficiency in all tissues and ultimately to metabolic disorders. There are different forms of shock, depending on the underlying cause.
Some leading symptoms are common to all shock types. These include a massive drop in blood pressure, which leads to the release of catecholamines (adrenaline, noradrenaline). These cause an increase in heart rate and a narrowing of the arterioles and venous capacity vessels.
Through this regulation, blood pressure can initially remain stable. The blood volume is redistributed to the most important organs (centralization). This includes the circulation of the
- Brain and the
- Of the heart.
At the beginning of the shock, the inflow of fluid from the tissue (interstitial fluid) increases regulatory to compensate for the lack of volume.
However, as the oxygen deficiency in the tissues increases, the amount of acidic metabolites (e.g. lactate) increases, causing the fluid in the vessels to decrease. As a result, the volume deficiency increases and the blood pressure continues to drop. The accumulation of acidic metabolites also causes the small arterial blood vessels to relax.
The small veins, however, do not slacken, which leads to blood congestion in the small arterial vessels. This leads to the formation of small clots, so-called microthrombi. Ultimately, these can obstruct the blood supply routes to the individual organs and lead to blood clotting (Disseminated intravascular coagulation).
This can be the cause of multiple organ failure and is in most cases fatal. Shock regulation has effects on all other organs.
- The kidney gives up its function and urine excretion is stopped, through which
- Reduced blood flow to the heart muscle increasingly leads to heart failure.
- Small embolisms form in the lungs,
- Pulmonary edema can develop and eventually lead to respiratory insufficiency. This is associated with a very high mortality rate.
