Shock Basics
The release of this hormone results in sodium/water retention, vasoconstriction, and the loss of Potassium.
What is Renin-angiotensin-aldosterone system!
The cardiovascular system has failed when a patient is dependent on these types of medication to maintain blood pressure despite adequate volume status
What is a vasopressor
Hgb should be kept between what range in shock patients?
What is 7-9%.
This is the presence of infection (probably or documented) together with systemic manifestations of infection
What is Sepsis
According to research presented in class, this is the first choice of vasopressor to give when a pt is in septic shock
What is Norepinephrine (levophed)
Respiratory Alkalosis during compensated shock is a result of?
What is Hyperventilation
This is a hematological complication of shock whereby all the clotting factors are used and results in excessive bleeding
What is DIC
Preload should be kept at between 8-12 with CVP monitoring. What two methods are used to assess preload responsiveness?
What is passive leg raise and stroke volume variation
This if the failure of the mitochondria
What is bioenergetic faliure
IV antibiotics should be given within how long of recognition of sever sepsis or septic shock
What is one hour
We perform lactate, base deficit, HCO3, and SVO2 to assess the effectiveness of this system?
What is Microcirculation?
Per Carlson, " When you loose the (blank), you loose the patient"
What is the gut
This intervention is a highly restricted practice with shock patients as it can decrease the ability to offload o2 to tissues and it is associated with increased nosocomial infections (Carlson bolded this in our notes)
What is blood transfusion
This is the most common source of sepsis in hospitalized patients
What is the lungs, likely from VAP
This is the target blood glucose of a patient in septic shock
What is <180 mg/dl
These are the three stages of shock
What is compensated , progressive and irreversible
ARDS is a complication of shock and results in a PaO2/Fi02 ratio less then what?
What is 300
During this phase of septic shock, the vascular response to the primary biochemical mediators is primarily vasodilation and cardiac output increases singificantly
What is hyperdynamic phase
RBC transfusion should only be given when Hgb is less then....
What is 7g/L
This is the progressive physiologic failure of 2 or more separate organ systems
What is MODS (multiple organ dysfunction syndrome)
The failure of this part of the brain results in thermoregulatory failure?
What is the hypothalamus
This lab determines the level of tissue hypoperfusion
What is lactate levels
This is the goal for MAP in a patient with septic shock
What is >65