Microvascular changes in shock

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  2. Why this site?
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  4. Stage 1: Pre-shock Anticipation
  5. Stage 2: Pre-shock Slide
  6. Stage 3: Compensated shock
  7. Stage 4: Decompensated shock, but reversible
  8. Stage 5: Decompensated shock, but irreversible
  9. Vicious cycles
  10. S.I.R.S.
  11. Shock Combo
  12. Microvascular Complications
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  14. EGDT
  15. Normotensive and Hypertensive (cryptic) Shocks
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In severe shock the microcirculation changes dramatically. Those changes are mainly due to a "cytokine storm" induced by extremely severe tissue ischemia or, directly, by a pathogen: (1) the endothelium is activated (vasodilates, becomes pro-coagulant, expresses adhesion molecules), (2) monocytes are activated (and discharge numerous cytokines), (3) white blood cells obstruct some capillaries (4) disseminated intra-vascular coagulation and platelet aggregation plug microcirculation as well.
When there is so much deterioration to the microcirculation, perfusion to organs worsens rapidly....and, as a consequence, systemic shock also worsens extremely rapidly... we are very close to the end, Folks...! ...(cute diagram but bad for the patient...)