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Hypovolemic & Septic Shock: Causes & Treatment

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  • 0:02 Four Different Types of Shock
  • 0:33 What Is Shock?
  • 1:34 Hemorrhagic &…
  • 3:32 Septic & Distributive Shock
  • 6:32 Signs & Treatments
  • 8:37 Lesson Summary
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Lesson Transcript
Instructor: Artem Cheprasov
This lesson will go over the pathophysiology of hypovolemic and septic shock. However, we will also cover what distributive, obstructive, neurogenic, anaphylactic, and septic shock are and how they relate to one another.

Four Different Types of Shock

Don't get too scared when I tell you that we'll be discussing many different types of shock in this lesson. It's not as shocking as it sounds since two of the main types I want to teach you about are kind of related to the others and so we'll really only be discussing a couple of main things. That should make it a little bit easier for you. Despite trying to make this lesson easier by combining things, the types of shock you'll learn about aren't easy on your body and are all emergency conditions.

What Is Shock?

To understand why, it's important to know what shock really is. Shock in a clinical sense has absolutely nothing to do with the emotional shock (good or bad) you may experience when you are proposed to, when you find out how massive your cell phone bill is, or the time you saw a pretty bad car accident. Shock in medicine refers to inadequate tissue perfusion in the body due to any number of causes.

In any case of shock, improper tissue perfusion of an organ results. Perfusion is how well-soaked your organs and tissues are with blood. In a more relatable sense, what I mean is, if a kitchen towel is soaked with water, then it's really well-perfused with water. If it's dry, then it's not well-perfused with water. If the cells, organs, and tissues of your body aren't soaked well enough with blood, then they aren't getting nutrients they need to stay alive. This obviously results in a person's death.

Hemorrhagic and Hypovolemic Shock

Since we are on the topic of blood here, one type of shock is known as hemorrhagic shock. This is a type of hypovolemic shock resulting from rapid and severe blood loss. Hypovolemic shock refers to improper tissue perfusion as a result of severe blood loss, other fluid loss from the body, or inadequate fluid intake, any of which end up decreasing intravascular fluid volume. By that definition, it should be clear that hypovolemic shock doesn't solely have to occur as a result of a loss of blood due to hemorrhage. Other fluid loss due to severe vomiting, diarrhea, kidney disease, or burns can also result in hypovolemic shock.

An obstruction in the GI tract, thereby limiting fluid intake, can also cause hypovolemic shock. This type of obstruction shouldn't be confused with obstructive shock, which is a completely separate category of shock that refers to obstruction of the outflow of blood from the heart. Hypovolemic shock due to hemorrhage is like having the pipes normally filled with water running throughout your house all of the sudden bursting open. This will lead to a decrease in water pressure and volume and therefore a decreased flow of water to places like your bathroom, kitchen sink, and so forth.

Similarly, in hypovolemic shock, a decrease in blood pressure (hypotension), intravascular blood volume, and adequate blood flow (tissue perfusion) to organs and tissues occurs. Like the pipes all of a sudden bursting open in your house, one similar event in real life that can cause hemorrhagic shock is the bursting open of an aortic aneurysm. An aneurysm is an abnormal distension or dilation of a blood vessel (in this case, the aorta).

Septic and Distributive Shock

Another form of shock is known as septic shock. This is a type of distributive shock resulting from sepsis. Sepsis is an abnormal body-wide inflammatory response to an infection that can result in death, whereas distributive shock is a form of shock in which severe vasodilation despite normal blood volume results in improper distribution of blood flow. Other causes of distributive shock include allergic reactions (anaphylactic shock), endocrine disease (addisonian crisis), and brain or spinal cord injuries (neurogenic shock).

To boil the massive complexities of everything down for you, if you get a severe enough infection with some nasty toxins being produced by the bacteria, then your body launches into a big defensive assault against the bacteria. Your body releases inflammatory mediators all over the place to try and counter this threat. However, these inflammatory mediators end up causing the dilation of blood vessels (known as vasodilation). Dilation of blood vessels results in decreased blood pressure. Decreased blood pressure impairs the delivery of blood to tissue organs, thereby decreasing tissue perfusion.

Let's examine why this is the case really quickly. If you have something like air under high pressure in a gas tank, then when you turn on the nozzle of the air tank, you can easily inflate a balloon. The inflation of that balloon with air thanks to high tank pressure is like the perfusion of an organ thanks to adequate blood pressure. But if the pressure in the tank of air drops, then when you turn the nozzle on, air will flow with very little force into the balloon, and this means the balloon won't inflate very well - that is to say, it won't be perfused with air very well.

All of this is coupled with the fact that the severe inflammatory response produces little blood clots all over the body. These blood clots prevent the flow of blood to your tissues and organs. Once again, this decreases tissue perfusion. It's as if something is stuck in the nozzle of the air tank, thereby preventing any air flow into the balloon.

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