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In the setting of head or neck trauma, an inadequate sympathetic response, or neurogenic shock, is a type of distributive shock that is caused by a decrease in peripheral vascular resistance. [3] This is suggested by an inappropriately low heart rate in the setting of hypotension. [ 3 ]
Capillary refill time is a quick and cheap way to indicate decreased peripheral perfusion and may indicate cardiovascular or respiratory dysfunction. [5] It has also been used to assess or diagnose diseases of the peripheral circulatory system such as Raynaud's syndrome and hand–arm vibration syndrome. [6]
In the cases of cardiogenic shock resulting from heart failure or acute hemorrhagic shock caused by a large volume of blood loss, the body constricts peripheral vessels to reverse the low arterial pressure that causes inadequate tissue perfusion. [22] With vasodilatory shock, it is difficult for the peripheral vascular smooth muscle to ...
The goal of treatment is to achieve a urine output of greater than 0.5 mL/kg/h, a central venous pressure of 8–12 mmHg and a mean arterial pressure of 65–95 mmHg. In trauma the goal is to stop the bleeding which in many cases requires surgical interventions. A good urine output indicates that the kidneys are getting enough blood flow.
The main goals of treatment in distributive shock are to reverse the underlying cause and achieve hemodynamic stabilization. [9] Immediate treatment involves fluid resuscitation and the use of vasoactive drugs, both vasopressors and inotropes . [ 10 ]
Peripheral vasoconstriction accounts for the cold extremities (hands and feet), increased heart rate, increased cardiac output (and associated chest pain). Eventually, there will be less perfusion to the kidneys, resulting in decreased urine output. [citation needed]
This causes them to relax (vasodilation) [4] resulting in a sudden decrease in blood pressure (secondary to a decrease in peripheral vascular resistance). Neurogenic shock results from damage to the spinal cord above the level of the 6th thoracic vertebra . [ 5 ]
A Lindbergh perfusion pump, c. 1935, an early device for simulating natural perfusion. Perfusion is the passage of fluid through the circulatory system or lymphatic system to an organ or a tissue, [1] usually referring to the delivery of blood to a capillary bed in tissue. Perfusion may also refer to fixation via perfusion, used in histological ...