Clinical Insights

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Abstract
The etiology of shock is wide ranging. Infection can lead to septic shock; hemorrhage, to hypovolemic shock; ventricular failure, to cardiogenic shock. But the problem common to any kind of shock is inadequate blood perfusion of tissues. This inadequate perfusion results in an oxygen demand that's greater than the oxygen supply. The usual cause of inadequate perfusion is inadequate cardiac output. The factors that decrease cardiac output can be grouped into two categories: (1) those that decrease the heart's ability to pump blood (for example, cardiogenic shock after a massive myocardial infarction) and (2) those that decrease venous return of blood to the heart so that circulating volume is inadequate (such as hypovolemic shock secondary to hemorrhage). This Clinical Insights explains the basic physiology of shock and tells you what to look for.

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