Use of Physiologic Reasoning to Diagnose and Manage Shock States

Table 1

Typical hemodynamic changes associated with three accepted categories of shock. Arrows show degree of change from baseline in blood pressure (BP), cardiac output (CO), systemic vascular resistance (SVR), and cardiac preload. Additionally, alterations in the relationship between oxygen delivery and demand (DO₂/VO₂) and mean arterial pressure and organ blood flow (MAP/OBF) are indicated. The asterisk (*) indicates the primary abnormality associated with each shock state.

Type of shock	BP	CO	SVR	Preload	DO2/VO2	MAP/OBF
Cardiogenic	nl-⇓	⇓⇓ ⇓ *	⇑⇑ ⇑	nl-⇑⇑	⇓⇓ ⇓	nl-⇓
Hypovolemic	nl-⇓	⇓	⇑⇑ ⇑	⇓⇓ ⇓ *	⇓⇓ ⇓	nl, ⇓
Distributive	⇓⇓	nl, ⇑⇑	⇓⇓ ⇓ *	⇓	nl-⇓	⇓⇓ ⇓

Abbreviation: nl = normal range; arrows show increases or decreases.