SHOCK

Coass Anestesi Periode 12 Desember 2017 – 13 Januari 2018

Definition
• Inadequate delivery of oxygen to the tissues leads to
“dysoxia”.
Normal Cardiovascular System
Classifications of Shock
Hypovolemia shock (exemplified
by hemorrhagic shock)

Obstructive shock (pulmonary

Hypodinamic embolism, cardiac tamponade,
tension pneumothorax)

Cardiogenic shock (as in an acute

myocardial infarction)

Shock Sepsis Shock

Anaphylaxis shock

Hyperdinamic/distributive or
Neurogenic Shock
vasodilatory shock

Liver failure

Adrenal crisis
Reperfusion Injury and the
Inflammatory Response
Ischemia

ATP
Oxygen free radicals
converted are then formed, lipid
mediators are
released.
Hypoxanthine

Endothelial cell
dysfunction, neutrophil
TNF-alfa, NO
chemotaxis,
microvascular changes

Tissue injury
Organ Failure

Cardiac
complications

Intestinal Renal
ischemia dysfunction

Respiratory
failure
Shock Hepatic injury

brain Hematologic
Initial Management
Of Shock
 Airway
ABC Breathing
Circulation
 Ventilate (Pemberian O2)

VIP rule Infuse (Cairan Resusitasi)

Pump (Pemberian obat vasoaktif)

General rule of management
Fluid
resuscitatio
n

Inotropic
support

Vasopressor
support
Monitoring

Physical
Hemodynamiics
examination

Acid-Base Regional
Status Measurements
Universal Algorithm