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Classification of shock
There are many classifications of shock, according to the leading trigger factor, the following types can be distinguished:
- hypovolemic;
- cardiogenic;
- obstructive;
- distributive (septic, anaphylactic, neurogenic).
Any given patient with shock may have pathogenetic features of several types of shock. For example, a child with multiple injuries may initially suffer from hypovolemic shock caused by hemorrhage, and may subsequently develop endotoxemia. Septic, anaphylactic, neurogenic, and other distributive shocks are accompanied by hypovolemia, which, however, is relative as a result of arterial and venous vasodilation, increased capillary permeability, and the movement of albumin into the interstitium.
It is customary to distinguish three stages of shock:
- compensated;
- hypotensive (decompensated);
- irreversible.
From a pathophysiological standpoint, shock conditions, regardless of the etiological factor, can be divided into two categories:
- with reduced cardiac output and impaired overall peripheral tissue perfusion;
- with normal or increased cardiac output and impaired distribution of peripheral blood flow. These groups can only be distinguished when hypovolemia has been corrected and adequate preload has been achieved.
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