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The aim is to achieve a systolic blood pressure of 90 mmHg in order to maintain tissue perfusion without inducing re-bleeding from recently clotted vessels. Permissive hypotension is a means of restricting fluid administration until hemorrhage is controlled while accepting a short period of suboptimal end-organ perfusion.
The diagnosis is generally based on a combination of symptoms, physical examination, and laboratory tests. [2] A decreased pulse pressure (systolic blood pressure minus diastolic blood pressure) or a fast heart rate raises concerns. [1] Shock is a medical emergency and requires urgent medical care.
The cause of inadequate tissue perfusion (blood delivery to tissues) in distributive shock is a lack of normal responsiveness of blood vessels to vasoconstrictive agents and direct vasodilation. [4] There are four types of distributive shock.
The major differential diagnosis is diabetic ketoacidosis (DKA). In contrast to DKA, serum glucose levels in HHS are extremely high, usually greater than 40-50 mmol/L (600 mg/dL). [6] Metabolic acidosis is absent or mild. [6] A temporary state of confusion (delirium) is also more common in HHS than DKA. HHS also tends to affect older people more.
Hypovolemia, also known as volume depletion or volume contraction, is a state of abnormally low extracellular fluid in the body. [1] This may be due to either a loss of both salt and water or a decrease in blood volume.
Septic shock is a result of a systemic response to infection or multiple infectious causes. The precipitating infections that may lead to septic shock if severe enough include but are not limited to appendicitis, pneumonia, bacteremia, diverticulitis, pyelonephritis, meningitis, pancreatitis, necrotizing fasciitis, MRSA and mesenteric ischemia.
Reperfusion injury, sometimes called ischemia-reperfusion injury (IRI) or reoxygenation injury, is the tissue damage caused when blood supply returns to tissue (re-+ perfusion) after a period of ischemia or lack of oxygen (anoxia or hypoxia).
Shock is defined as insufficient perfusion or blood flow to organs and body tissue that causes organ and tissue dysfunction, [2] [1] and can be divided into different types depending on the cause and symptoms. A common type of surgical shock is hypovolemic shock, which is often caused by blood loss.