Medicine
Volume 37, Issue 1 , Pages 6-10, January 2009

Shock

Kenwyn James FRCA MRCP BA (Hons) is a Specialist Registrar in Anaesthesia and Critical Care at Southampton General Hospital, Southampton, Hampshire, UK. Competing interests: none declared

Max Jonas FRCA is a Consultant and Honorary Senior Lecturer in Critical Care at Southampton General Hospital, Southampton, Hampshire, UK. Competing interests: none declared

Abstract 

Shock is a frequently misused and misunderstood term. When used to describe the process of tissue hypoperfusion, leading to cellular hypoxia and organ failure, it describes a medical emergency with a high mortality. Early recognition of the condition and prompt, appropriate management is essential to increase survival. This includes timely use of appropriate monitoring including clinical signs, biochemical tests, and invasive pressure and flow monitoring. In carefully selected patients, measurement and manipulation of oxygen delivery has been shown to improve outcome. Rapid identification of the underlying cause and definitive treatment are needed to reduce morbidity and mortality. In the clinical scenario of septic shock, early antibiotics are vital. Every hour’s delay in the administration of appropriate antibiotics is associated with approximately an 8% decrease in survival.

Keywords: antibiotics, hypoperfusion, hypovolaemia, oxygen delivery, septic shock, shock

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PII: S1357-3039(08)00308-3

doi:10.1016/j.mpmed.2008.10.004

Medicine
Volume 37, Issue 1 , Pages 6-10, January 2009