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Shock in the Operating Room

Practice Essentials

Key points in the management of shock in the operating room (OR) include the following:

Shock results from circulatory failure that leads to poor tissue perfusion and inadequate oxygenation

There are four types of shock:
distributive,
cardiogenic,
hypovolemic, and obstructive

Subtypes of distributive shock include
septic shock, neurogenic shock, and
anaphylactic shock

The most common form of shock in the intensive care unit (ICU) is septic shock (distributive category), whereas the most common form of shock in a trauma patient is
hemorrhagic shock

 (hypovolemic category)

It is important to use diagnostic clues in the history, physical examination, laboratory studies, diagnostic imaging, and hemodynamic profile in order to determine the etiology of shock, while keeping in mind that more than one type of shock might be present

During the induction of anesthesia in patients with shock, it is prudent to avoid agents that confer hemodynamic instability

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