Table 2 Abnormalities leading to hypotension in various shock states, including septic shock
Shock type | Venous return | Pump function | Vascular tone | Other abnormalities | Examples |
|---|---|---|---|---|---|
Cardiogenic | Normal or ↑ | ↓↓ | Normal or ↑ | Primary pump failure, may develop compensatory salt/water retention and increased vascular tone | Myocardial infarction, injury |
Neurogenic | ↓ | ↓↓ | ↓↓ | Loss of inotropic/chronotropic input and vascular tone | High cervical transection, spinal anesthetic |
Distributive | ↓↓ | Normal (may ↑ or ↓, depending on etiology and compensation) | ↓ | Mediators dilate a vascular tree that cannot be filled with the existing blood volume | Anaphylaxis, adrenal insufficiency, SIRS response |
Septic | ↓↓ | ↑ or normal, but can be ↓↓ | ↓↓ | Dysfunctions in 1. Vascular tone leading to pooling of venous blood, 2. Myocardial pumping 3. Vascular tone, contributing to hypotension | Peritonitis, pneumonia, urosepsis |