Ellender Timothy J, Skinner Joseph C
Department of Emergency Medicine, Indiana University Hospital, Emergency Medical Group Inc., 1701 North Senate Boulevard EMTC-AG001, Indianapolis, IN 46202, USA.
Emerg Med Clin North Am. 2008 Aug;26(3):759-86, ix. doi: 10.1016/j.emc.2008.04.001.
Shock is a final common pathway associated with regularly encountered emergencies including myocardial infarction, microbial sepsis, pulmonary embolism, significant trauma, and anaphylaxis. Shock results in impaired tissue perfusion, cellular hypoxia, and metabolic derangements that cause cellular injury. The clinical manifestations and prognosis of shock are largely dependent on the etiology and duration of insult. It is important that emergency physicians, familiar with the broad differential diagnosis of shock, be prepared to rapidly recognize, resuscitate, and target appropriate therapies aimed at correcting the underlying process. This article focuses on the basic pathophysiology of shock states and reviews the rationale regarding vasoactive drug therapy for cardiovascular support of shock within an emergency environment.
休克是一种与常见紧急情况相关的最终共同途径，这些紧急情况包括心肌梗死、微生物败血症、肺栓塞、严重创伤和过敏反应。休克会导致组织灌注受损、细胞缺氧和代谢紊乱，进而引起细胞损伤。休克的临床表现和预后很大程度上取决于病因和损伤持续时间。急诊医生熟悉休克的广泛鉴别诊断，做好迅速识别、复苏并针对潜在病因进行适当治疗的准备非常重要。本文重点介绍休克状态的基本病理生理学，并回顾在紧急情况下用于休克心血管支持的血管活性药物治疗的基本原理。
