Shock involves various common clinical critical illnesses. Shock refers to the pathological process of microcirculation disorders caused by various reasons, severe insufficiency of microvascular blood perfusion in tissues and organs, tissue cells ischemia and hypoxia, which cause dysfunction and metabolism of vital organs such as heart, brain, and kidney. Its typical clinical manifestations are decreased blood pressure, narrow pulse, pale skin fur, cold limbs, decreased urine output, indifference, and severe coma and even death.
There are many reasons for shock, the main ones are as follows:
(1) Blood loss or fluid loss: A large amount of blood loss can cause hemorrhagic shock, which is common in traumatic hemorrhage, gastrointestinal hemorrhage, liver or spleen rupture and ectopic pregnancy hemorrhage, etc., severe vomiting, diarrhea, a large amount of fluid loss. The loss of body fluids can also cause a sharp decrease in the effective circulating blood volume. It was called "expansion" in the past. It is now believed that collapse and hemorrhagic shock are similar in nature and manifestations, and both are caused by hypovolemia.
(2) Trauma: Severe trauma can cause traumatic shock, which can be seen in fractures, crush injuries, war injuries, traffic accidents and major surgical operations.
(3) Acute heart failure: Extensive myocardial infarction, acute myocarditis, pericardial tamponade and severe arrhythmia cause a significant reduction in cardiac output, which is called cardiogenic shock.
(4) Infection: Severe infection of various pathogenic microorganisms, especially Gram-negative bacterial infection can cause septic shock. The common ones are septic shock, septic shock, and toxic shock.
(5) Allergy: Shock caused by the body's allergy to certain drugs (such as penicillin) serum products or vaccines, foreign proteins, etc.
(6) Strong nerve stimulation: severe pain, high spinal anesthesia or injury can cause neurogenic shock.
Due to shock, the body's tissue cells and various organs will be hypoxic. Although the human kidney is not large, the blood vessels and capillaries in the kidney are very rich, so the blood flow is quite large. In shock, renal blood flow is reduced and the kidney is hypoxic, which can cause oliguria, hyperkalemia, acidosis, and renal failure. Renal failure due to shock is called "shock kidney." In shock, the blood flow of the pulmonary blood vessels is reduced, and the lung is hypoxic, causing lung damage, such as atelectasis, edema and hemorrhage, which makes hypoxia more serious, and acute respiratory failure often occurs. These lesions used to be called "shock lungs" and now belong to the category of adult respiratory distress syndrome (ARDS). ARDS accounts for about one-third of shock deaths. The heart consumes a lot of oxygen, and the coronary arteries that nourish the heart must have sufficient blood flow to ensure the heart's demand for nutrients and oxygen. Except for cardiogenic shock accompanied by primary cardiac dysfunction, in other shocks, acute heart failure occurs due to a significant decrease in coronary blood flow, myocardial ischemia and hypoxia, and cardiac pump dysfunction. The brain’s demand for oxygen is relatively higher than that of other organs. Once ischemia for about 10 minutes, the patient may develop cerebral edema and coma, which may cause irreversible damage and even become an unconscious “vegetable”. In addition, When the liver and the digestive tract is in shock, there will be varying degrees of damage due to hypoxia.
Shock can be divided into three stages according to the changes of microvascular: early shock, shock stage and late shock. The clinical manifestations of patients with early shock include pale face, cold limbs, cold sweats, fine pulse, reduced pulse pressure, decreased urine output, irritability, and generally clear consciousness. As the disease progresses, the patient's response is slow and blood pressure progresses. Decline in sex, change of consciousness from apathy to coma, oliguria or anuria, cyanosis of the skin, mottling, and finally acute failure of the heart, kidneys, lungs and other organs.
Shock is a serious and varied pathological process, which requires timely rescue and close observation of changes in the condition. If the shock develops to an advanced stage, it is difficult to reverse the general treatment principle is to carry out intravenous infusion and administration as soon as possible. The content of the infusion should be selected according to the specific situation with whole blood, plasma, and low molecular dextran. To improve the blood supply of capillaries, choose vasodilators according to the situation, such as sodium nitroprusside, atropine, anisodamine, etc. Different types of shock are treated differently and adjusted according to the condition.
No matter what kind of shock, the patient should inhale enough oxygen. Oxygen delivery can maintain normal or close to normal arterial oxygen, which is conducive to organs getting the maximum amount of oxygen, that is, oxygen emergency. Our medical oxygen concentrator 10L will be very useful for the patient.
When the patient inhales air with a high oxygen concentration (28-21%), oxygen is immediately sent to the lung cells, passes through the alveolar-capillary membrane to reach the capillaries, and then combines with the hemoglobin in the red blood cells to directly saturate the blood oxygen content Rise rapidly. In this way, carbon dioxide can be effectively prevented from accumulating in the body, the gas in the alveoli is constantly renewed, and the oxygen content in the tissue increases, so that the body's need for oxygen can be maintained when the disease occurs.