Rackow E C, Weil M H
St. Vincent's Hospital and Medical Center, New York Medical College, NY 10011.
Clin Chem. 1990 Aug;36(8 Pt 2):1544-6.
The primary defect that characterizes circulatory shock is acute perfusion failure, in which oxygen metabolism is critically impaired by decreased delivery of oxygen to tissues. Four categories of hemodynamic deficits are described as the basic mechanisms of circulatory shock: hypovolemia, cardiac failure, distributive deficits, and vascular obstruction. Perfusion failure can be identified by the development of lactic acidosis, because anaerobic metabolism is the consequence of the oxygen deficit during circulatory failure. Lactic acidosis at present represents the best single objective measure of the severity of shock.
循环性休克的主要特征性缺陷是急性灌注衰竭，即由于输送到组织的氧气减少，氧代谢严重受损。四类血流动力学缺陷被描述为循环性休克的基本机制：血容量不足、心力衰竭、分布性缺陷和血管阻塞。灌注衰竭可通过乳酸酸中毒的发生来识别，因为无氧代谢是循环衰竭期间氧缺乏的结果。目前，乳酸酸中毒是休克严重程度的最佳单一客观指标。
