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SHOCK

...

Shock : ,

( )


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, & &

:
O2 =>

=> CO2 &


&

&
http://www.merckmanuals.com/professional/sec06/ch067/ch067b.html





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(.. , , TNF)

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kappa B (NFB), &
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ATP
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shock

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: ,

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shock
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(

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& :

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( ) (, ,
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Gram(-)

shock


(, )

=>

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=>
=> =>

()
60 mmHg =>

=>

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)
ARDS

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-:
-
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LDH,

& => stress ulcer, ,

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I ( ): ,

, ..
II ( ):

.. <90mmHg

,, ,

(, , ,
, )

<20 ml/- Na+ <30 mq/l

III: ,

, , ,

( I)
<20%


(,
,,).
pH

.
. &
.

( II)
20-40%


(, ,
).

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( ). &

( III)
>40%

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PEEP

(

& &
)
: ,
,


2

=> (500 ml)
: 38-40%
: , , ,
(
& )-


mast
(5-10 mcg/kg/min) &
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:
(, ,

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( )

, ,
- (

)
(

)
( &

)
(2-5 g/kg/min

=> /
)

:

( ,

, ,
, ST):

/

(bypass)

:
( shock, ):

0,05-0,01 mg V 1-1,5 &




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