Universität zu Köln

Standl, Thomas, Annecke, Thorsten ORCID: 0000-0002-2496-4432, Cascorbi, Ingolf ORCID: 0000-0002-2182-9534, Heller, Axel R. ORCID: 0000-0001-6144-3874, Sabashnikov, Anton and Teske, Wolfram (2018). The Nomenclature, Definition and Distinction of Types of Shock. Dtsch. Arztebl. Int., 115 (45). S. 757 - 771. COLOGNE: DEUTSCHER AERZTE-VERLAG GMBH. ISSN 1866-0452

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Abstract

Background: A severe mismatch between the supply and demand of oxygen is the common feature of all types of shock. We present a newly developed, clinically oriented classification of the various types of shock and their therapeutic implications. Methods: This review is based on pertinent publications (1990-2018) retrieved by a selective search in PubMed, and on the relevant guidelines and meta-analyses. Results: There are only four major categories of shock, each of which is mainly related to one of four organ systems. Hypovolemic shock relates to the blood and fluids compartment while distributive shock relates to the vascular system; cardiogenic shock arises from primary cardiac dysfunction; and obstructive shock arises from a blockage of the circulation. Hypovolemic shock is due to intravascular volume loss and is treated by fluid replacement with balanced crystalloids. Distributive shock, on the other hand, is a state of relative hypovolemia resulting from pathological redistribution of the absolute intravascular volume and is treated with a combination of vasoconstrictors and fluid replacement. Cardiogenic shock is due to inadequate function of the heart, which shall be treated, depending on the situation, with drugs, surgery, or other interventional procedures. In obstructive shock, hypoperfusion due to elevated resistance shall be treated with an immediate life-saving intervention. Conclusion: The new classification is intended to facilitate the goal-driven treatment of shock in both the pre-hospital and the inpatient setting. A uniform treatment strategy should be established for each of the four types of shock.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Standl, Thomas UNSPECIFIED UNSPECIFIED UNSPECIFIED Annecke, Thorsten UNSPECIFIED orcid.org/0000-0002-2496-4432 UNSPECIFIED Cascorbi, Ingolf UNSPECIFIED orcid.org/0000-0002-2182-9534 UNSPECIFIED Heller, Axel R. UNSPECIFIED orcid.org/0000-0001-6144-3874 UNSPECIFIED Sabashnikov, Anton UNSPECIFIED UNSPECIFIED UNSPECIFIED Teske, Wolfram UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-165832
DOI:	10.3238/arztebl.2018.0757
Journal or Publication Title:	Dtsch. Arztebl. Int.
Volume:	115
Number:	45
Page Range:	S. 757 - 771
Date:	2018
Publisher:	DEUTSCHER AERZTE-VERLAG GMBH
Place of Publication:	COLOGNE
ISSN:	1866-0452
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language INTERNATIONAL CONSENSUS DEFINITIONS; HEMORRHAGIC-SHOCK; TRANEXAMIC ACID; CARDIOGENIC-SHOCK; NEUROGENIC SHOCK; TRAUMA PATIENTS; SEPTIC SHOCK; SEPSIS; RESUSCITATION; THERAPY Multiple languages Medicine, General & Internal Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/16583