Şok
Özet
Şok dolaşım, doku pefüzyonu, hemostatik mekanizmalarda akut olarak oluşan bozulmadır. Temel patoloji doku hipoperfüzyonudur. 4 farklı sebep ‘distrubutif, kardiyojenik, hipvolemik ve obstruktif şok’ olarak tanımlayabiliriz. Şokun etyolojisini tanımlayıp tedavisi için uygun sıvı replasmanı sonrasında hastaya uygun vazopresör tedaviyi planlamak gerekir. Vazopresör tedavide adrenerjik reseptörlerin ana kategorileri; alfa-1, beta-1, beta-2 adrenerjik ve dopaminerjik reseptörlerdir. Şok takip ve tedavisinde sıvı yanıtlılığı-volüm durumu, kardiyak output ve doku oksijenizasyonunu objektif olarak değerlendirebiliriz.
Shock is an acute disruption in circulation, tissue perfusion and hemostatic mechanisms. The main pathology is tissue hypoperfusion. We can define 4 different causes as 'distributive, cardiogenic, hypovolemic and obstructive shock'. It is necessary to identify the etiology of shock and plan appropriate vasopressor treatment for the patient after appropriate fluid replacement for its treatment. The main categories of adrenergic receptors in vasopressor therapy are; alpha- 1, beta-1, beta-2 are adrenergic and dopaminergic receptors. We can evaluate fluid responsiveness-volume status, cardiac output and tissue oxygenation in shock with monitoring objectively and plan treatment.
Referanslar
Vincent JL, De Backer D. Circulatory shock. N Engl J Med 2013; 369:1726.
De Backer D, Biston P, Devriendt J, et al. Comparison of dopamine and norepinephrine in the treatment of shock. N Engl J Med 2010; 362:779.
Kheng CP, Rahman NH. The use of end-tidal carbon dioxide monitoring in patients with hypotension in the emergency department. Int J Emerg Med 2012; 5:31.
Jones AE, Craddock PA, Tayal VS, Kline JA. Diagnostic accuracy of left ventricular function for identifying sepsis among emergency department patients with nontraumatic symptomatic undifferentiated hypotension. Shock 2005; 24:513.
Fuller BM, Dellinger RP: Lactate as a hemodynamic marker in the critically ill. Curr Opin Crit Care. 2012, 18: 267-272. 10.1097/MCC.0b013e3283532b8a.
Singer M, Deutschman CS, Seymour CW, et al. The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA 2016; 315:801.
Miniksar ÖA, Aydın A, Kaçmaz O, et al. Yoğun Bakım Ünitesine Yatış Endikasyonlarının Önemli Bir Nedeni: Akut İlaç İntoksikasyonları. J Cukurova Anesth Surg. 2021;4(1):45-52. Doi: 10.36516/jocass.2021.71.
Ponikowski P, Voors AA, Anker SD, et al. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC). Developed with the special contribution of the Heart Failure Association (HFA) of the ESC. Eur Heart J 2016;37:2129-200.
(VP Harjola, J Lassus, A Sionis et al. Clinical picture and risk prediction of short-term mortality in cardiogenic shock. Eur J Herat Fail, 17 (2015), pp. 501-509.
Shankar-Hari M, Phillips GS, Levy ML, et al. Developing a New Definition and Assessing New Clinical Criteria for Septic Shock: For the Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA 2016; 315:775.
American College of Surgeons. Advanced Trauma Life Support (Student Manual). American College of Surgeons 1997.
Berger T, Green J, Horeczko T, et al. Shock index and early recognition of sepsis in the emergency department: pilot study. West J Emerg Med 2013;14:168-74.
Botsch A, Firstenberg MS. Comment on the Edwards FloTrac/Vigileo versus pulmonary artery catheter study: What is really going on with this patient? Int J Crit Illn Inj Sci 2017;7:183-4. 10.4103/IJCIIS.IJCIIS_44_17
Michard F, Teboul JL. Predicting fluid responsiveness in ICU patients: a critical analysis of the evidence. Chest 2002; 121:2000.
Pinsky MR. Functional haemodynamic monitoring. Curr Opin Crit Care 2014; 20:288.
Marik PE. Baram M, Vahid P. Does central venous pressure predict fluid responsiveness? A systematic review of the literature and the tale of seven mares. Chest 2008;134:172.
Jones AE, Tayal VS, Kline JA. Focused training of emergency medicine residents in goal-directed echocardiography: a prospective study. Acad Emerg Med 2003; 10:1054.
Rudski LG, Lai WW, Afilalo J, et al. Guidelines for the echocardiographic assessment of the right heart in adults: a report from the American Society of Echocardiography endorsed by the European Association of Echocardiography, a registered branch of the European Society of Cardiology, and the Canadian Society of Echocardiography. J Am Soc Echocardiogr 2010; 23:685.
Marik PE, Baram M. Noninvasive hemodynamic monitoring in the intensive care unit. Crit Care Clin 2007; 23:383.
Marik PE. Noninvasive cardiac output monitors: a state-of the-art review. J Cardiothorac Vasc Anesth 2013; 27:121.
Vignon P, Mücke F, Bellec F, et al. Basic critical care echocardiography: validation of a curriculum dedicated to noncardiologist residents. Crit Care Med 2011; 39:636.
Mandeville JC, Colebourn CL. Can transthoracic echocardiography be used to predict fluid responsiveness in the critically ill patient? A systematic review. Crit Care Res Pract 2012; 2012:513480.
De Backer D, Creteur J, Dubois MJ, et al. Microvascular alterations in patients with acute severe heart failure and cardiogenic shock. Am Heart J 2004; 147:91.
De Backer D, Donadello K, Sakr Y, et al. Microcirculatory alterations in patients with severe sepsis: impact of time of assessment and relationship with outcome. Crit Care Med 2013; 41:791.
Lima AP, Beelen P, Bakker J. Use of a periphera perfusion index derived from the pulse oximetry signal as a noninvasıve indicator of perfusion. Crit Care Med.2002;30:1210-3.
Referanslar
Vincent JL, De Backer D. Circulatory shock. N Engl J Med 2013; 369:1726.
De Backer D, Biston P, Devriendt J, et al. Comparison of dopamine and norepinephrine in the treatment of shock. N Engl J Med 2010; 362:779.
Kheng CP, Rahman NH. The use of end-tidal carbon dioxide monitoring in patients with hypotension in the emergency department. Int J Emerg Med 2012; 5:31.
Jones AE, Craddock PA, Tayal VS, Kline JA. Diagnostic accuracy of left ventricular function for identifying sepsis among emergency department patients with nontraumatic symptomatic undifferentiated hypotension. Shock 2005; 24:513.
Fuller BM, Dellinger RP: Lactate as a hemodynamic marker in the critically ill. Curr Opin Crit Care. 2012, 18: 267-272. 10.1097/MCC.0b013e3283532b8a.
Singer M, Deutschman CS, Seymour CW, et al. The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA 2016; 315:801.
Miniksar ÖA, Aydın A, Kaçmaz O, et al. Yoğun Bakım Ünitesine Yatış Endikasyonlarının Önemli Bir Nedeni: Akut İlaç İntoksikasyonları. J Cukurova Anesth Surg. 2021;4(1):45-52. Doi: 10.36516/jocass.2021.71.
Ponikowski P, Voors AA, Anker SD, et al. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC). Developed with the special contribution of the Heart Failure Association (HFA) of the ESC. Eur Heart J 2016;37:2129-200.
(VP Harjola, J Lassus, A Sionis et al. Clinical picture and risk prediction of short-term mortality in cardiogenic shock. Eur J Herat Fail, 17 (2015), pp. 501-509.
Shankar-Hari M, Phillips GS, Levy ML, et al. Developing a New Definition and Assessing New Clinical Criteria for Septic Shock: For the Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA 2016; 315:775.
American College of Surgeons. Advanced Trauma Life Support (Student Manual). American College of Surgeons 1997.
Berger T, Green J, Horeczko T, et al. Shock index and early recognition of sepsis in the emergency department: pilot study. West J Emerg Med 2013;14:168-74.
Botsch A, Firstenberg MS. Comment on the Edwards FloTrac/Vigileo versus pulmonary artery catheter study: What is really going on with this patient? Int J Crit Illn Inj Sci 2017;7:183-4. 10.4103/IJCIIS.IJCIIS_44_17
Michard F, Teboul JL. Predicting fluid responsiveness in ICU patients: a critical analysis of the evidence. Chest 2002; 121:2000.
Pinsky MR. Functional haemodynamic monitoring. Curr Opin Crit Care 2014; 20:288.
Marik PE. Baram M, Vahid P. Does central venous pressure predict fluid responsiveness? A systematic review of the literature and the tale of seven mares. Chest 2008;134:172.
Jones AE, Tayal VS, Kline JA. Focused training of emergency medicine residents in goal-directed echocardiography: a prospective study. Acad Emerg Med 2003; 10:1054.
Rudski LG, Lai WW, Afilalo J, et al. Guidelines for the echocardiographic assessment of the right heart in adults: a report from the American Society of Echocardiography endorsed by the European Association of Echocardiography, a registered branch of the European Society of Cardiology, and the Canadian Society of Echocardiography. J Am Soc Echocardiogr 2010; 23:685.
Marik PE, Baram M. Noninvasive hemodynamic monitoring in the intensive care unit. Crit Care Clin 2007; 23:383.
Marik PE. Noninvasive cardiac output monitors: a state-of the-art review. J Cardiothorac Vasc Anesth 2013; 27:121.
Vignon P, Mücke F, Bellec F, et al. Basic critical care echocardiography: validation of a curriculum dedicated to noncardiologist residents. Crit Care Med 2011; 39:636.
Mandeville JC, Colebourn CL. Can transthoracic echocardiography be used to predict fluid responsiveness in the critically ill patient? A systematic review. Crit Care Res Pract 2012; 2012:513480.
De Backer D, Creteur J, Dubois MJ, et al. Microvascular alterations in patients with acute severe heart failure and cardiogenic shock. Am Heart J 2004; 147:91.
De Backer D, Donadello K, Sakr Y, et al. Microcirculatory alterations in patients with severe sepsis: impact of time of assessment and relationship with outcome. Crit Care Med 2013; 41:791.
Lima AP, Beelen P, Bakker J. Use of a periphera perfusion index derived from the pulse oximetry signal as a noninvasıve indicator of perfusion. Crit Care Med.2002;30:1210-3.
