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The latter hypothesis is supported by the frequent finding of diffuse blood vessel spasms (vasoconstriction) in many people with PRES, [1] and the evidence for decreased perfusion, [5] although the spasm may also be a consequence of the blood vessel damage rather than the cause. [4] Some, therefore, include the vasospasm in the "toxic" theory. [3]
Coronary perfusion pressures are decreased by these factors, which also increase myocardial oxygen consumption, possibly leading to left ventricular hypertrophy. As the left ventricle becomes unable to compensate for an acute rise in systemic vascular resistance, left ventricular failure and pulmonary edema or myocardial ischemia may occur.
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.
This decrease in peripheral vascular resistance is normally compensated for by an increase in the cardiac output. Since people with severe AS cannot increase their cardiac output, the blood pressure falls and the person will faint due to decreased blood perfusion to the brain .
Neurogenic shock is diagnosed based on a person's symptoms and blood pressure levels. Neurogenic shock's presentation includes: [7] [8] - warm and pink skin - labored breathing - low blood pressure - dizziness - anxiety - history of trauma to head or upper spine. - if the injury is to the head or neck, hoarseness or difficulty swallowing may occur.
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 ]
Agitation, lethargy, or confusion may characterize brain mal-perfusion. [4] Dry mucous membranes, decreased skin turgor, low jugular venous distention, tachycardia, and hypotension can be seen along with decreased urinary output. [4] Patients in shock can appear cold, clammy, and cyanotic. [4]