Shock Types - Classification
State of cellular and tissue hypoxia due to: reduced oxygen delivery, increased oxygen consumption, inadequate oxygen utilization, or a combination of these processes.
Stages:
1. PRE-SHOCK - Compensated shock, cryptic shock. Compensatory responses to diminished tissue perfusion
2. SHOCK - Compensatory mechanisms become overwhelmed, symptomatic tachycardia, dyspnea, cold clammy skin, altered mentation
3. END-ORGAN DYSFUNCTION - Irreversible end-organ damage, multisystem organ failure, and death
DISTRIBUTIVE (Warm and Dry) - Most common type (66% of shock)
 • Septic → dysregulated host response to infection
 • Neurogenic → in severe traumatic brain or spinal cord injury
 • Anaphylactic → severe lgE-mediated reaction
 • Endocrine/Metabolic → addisonian crisis, myxedema, beriberi
CARDIOGENIC (Cold and Wet):
 • Cardiomyopathic → myocardial infarction, following cardiac arrest or decompensated heart failure,thyrotoxicosis
 • Arrhythmic → tachyarrhythmias or bradyarrhythmias
 • Mechanical → severe aortic or mitral insufficiency, acute valvular rupture, dissection of ascending aorta into valve ring
OBSTRUCTIVE (Cold and Dry)
 • Puimonary vascular → RV failure from massive pulmonary embolism or severe pulmonary hypertension
 • Mechanical (impaired venous return/ventricular filling) → tension pneumothorax, cardiac tamponade, constrictive pericarditis, restrictive cardiomyopathy
HYPOVOLEMIC (Cold and Dry):
 • Hemorrhagic → leading to reduced intravascular volume. Most commonly due to trauma or gastrointestinal bleeding
 • Nonhemorrhagic → volume depletion due to loss of Sodium and water

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