Changes of the body when shocked

The article is professionally consulted by Master, Doctor Phan Ngoc Toan - Emergency Medicine Doctor - Emergency Department - Vinmec Danang International Hospital.

When the body is in shock, compensatory mechanisms are immediately activated in response to tissue hypoperfusion. However, when this mechanism is no longer able to compensate for the body's needs, severe signs of shock can occur. Early therapeutic intervention can help patients recover, but if left untreated, it can lead to organ dysfunction and death.

Shock is a state of impaired circulatory function that leads to decreased perfusion of living tissue with consequent cellular dysfunction, multiple organ failure, and death. Shock is divided into 4 main groups:

Hypovolemic shock: A condition in which the body loses a large volume of circulation that has not been properly and promptly compensated. Causes of intravascular volume depletion may be hemorrhagic (trauma, gastrointestinal bleeding, haemorrhagic rupture of hemangiomas ...) and non-hemorrhagic (diarrhea, vomiting, renal dehydration due to administration of the drug). diuretics, burns...). Cardiogenic shock: Cardiogenic shock is a state of shock caused by pathological diseases of the heart, leading to a decrease in the heart's ability to pump blood, thereby causing a decrease in cardiac output. Causes may be due to pathology including cardiomyopathy (myocardial infarction, coronary insufficiency, dilated cardiomyopathy, heart failure, myocarditis...), arrhythmia (paroxysmal supraventricular tachycardia, complete atrioventricular block...) and due to valvular disease (severe aortic insufficiency, acute regurgitation...). Anaphylaxis: Is a state of shock when the body comes into contact with an allergen, be it food, medicine, etc. It is a severe allergic reaction to an allergen and can lead to death. Septic shock: This is the result of organ failure due to the body's inability to adjust in response to infection. It can be caused by bacteria such as staphylococcus aureus, pneumococcus, Klebsiella... caused. This condition causes disturbances in the distribution of oxygen and blood to the body due to peripheral vasodilation.

When shock occurs, causing hypoperfusion and decreased oxygen supply, or cells inappropriately use oxygen for aerobic metabolism, cells switch to anaerobic metabolism with increased produce CO2 and increase the amount of lactate in the blood. Cell function declines and, if untreated, shock persists, irreversible cell damage and death.

The body changes according to each stage of shock:
First stage: Also known as the compensatory phase, the body has compensatory mechanisms for reduced organ tissue perfusion. When organ ischemia and reduced oxygen supply are detected, the body responds with the release of catecholamines, increased activity of the renin-angiotensin system, activation of the sympathetic nervous system causing selective vasoconstriction. filter, shunt blood to the heart and brain, increase myocardial contractility to raise blood pressure. Increased release of glucocorticoids and mineralocorticoids to increase blood glucose levels, increased blood glucose can put pressure on dormant mitochondria, causing lactate production. Due to insufficient oxygen source, the body will switch to anaerobic metabolism, increasing the production of lactic acid. Due to a compensatory mechanism, in the early stages of shock, the patient may not have obvious symptoms, and the blood pressure has not decreased. However, tachycardia, mild changes in arterial blood pressure, or mild to moderate hyperlactatemia are early manifestations of shock. Stage of shock: This condition occurs when the body's compensatory mechanisms are overloaded and signs of dysfunction begin to appear. Manifestations at this stage include symptoms such as tachycardia, small, difficult to catch, shortness of breath, agitation, sweating, lactic acidosis, low blood pressure, little urination, cold and moist skin. . Organ dysfunction stage: This is the final stage of shock, which represents progressive dysfunction of at least 2 organs, resulting in life-threatening consequences. When this happens, it can affect and lead to many signs on organs such as: + Lungs: Increased membrane permeability leads to effusion in the alveoli, severe can be resistant to O2 therapy. cause respiratory failure;
+ Kidneys: Decreased blood flow to the kidneys leads to acute tubular necrosis, renal failure causes anuria and increased blood creatinine levels;
+ Heart: Decreased blood flow to the coronary arteries, decreased myocardial contractility, decreased cardiac output, decreased blood pressure can cause arrhythmias. Formation of a pathological spiral;
+ The condition manifests in the organs and is accompanied by severe hyperlactatemia, resistant to treatment measures leading to coma. Death is common during this stage of shock.

In stages of shock, prompt and correct therapeutic intervention helps the patient recover. However, if detected late at the end stage, the response rate to treatment is low and the risk of death is high. Currently, Vinmec International General Hospital is one of the leading prestigious hospitals in the country, trusted by a large number of patients for medical examination and treatment. Not only the physical system, modern equipment: 6 ultrasound rooms, 4 DR X-ray rooms (1 full-axis machine, 1 light machine, 1 general machine and 1 mammography machine) , 2 DR portable X-ray machines, 2 multi-row CT scanner rooms (1 128 rows and 1 16 arrays), 2 Magnetic resonance imaging rooms (1 3 Tesla and 1 1.5 Tesla), 1 room for 2 levels of interventional angiography and 1 room to measure bone mineral density.... Vinmec is also the place to gather a team of experienced doctors and nurses who will greatly assist in diagnosis and detection. early signs of abnormality in the patient's body. In particular, with a space designed according to 5-star hotel standards, Vinmec ensures to bring the patient the most comfort, friendliness and peace of mind.