Pathophysiology, Diagnosis and Comprehensive Management of Shock | Emergency and Critical Care Medicine

Emergency · Clinical Specialties

How it begins

A comprehensive analysis of systemic tissue hypoperfusion status. From microcirculatory mitochondrial damage to contemporary guidelines for resuscitation and multimodal vasopressor support in critically ill patients.

What it covers

1. Pathophysiology and Comprehensive Management of Shock
2. Cellular Physiopathology, Microcirculation and Bioenergetic Dysoxia
3. · 1.1 · Fundamental equations of oxygen transport ($DO_2$ and $VO_2$)
4. · 1.2 · Microcirculation and glycocalyx dysfunction
5. · 1.3 · Biochemistry of cellular hypoxia and lactate type A vs Type B
6. Classification and Specific Pathophysiology of Shock Phenotypes
7. · 2.1 · Neuroendocrine compensation mechanisms (Compensated phase)
8. · 2.2 · Loss of compensation and refractory vasoplegia
9. Clinical Evaluation, Tissue Perfusion and Biomarkers
10. · 3.1 · The three windows of clinical perfusion
11. · 3.2 · Metabolic parameters and their prognostic value
12. Advanced Hemodynamic Monitoring and interactivity
13. · 4.1 · Dynamic evaluation of response to fluids (Fluid responsiveness)
14. · 4.2 · Pulmonary Artery Catheter (Swan-Ganz) and Transpulmonary Thermodilution (PiCCO)
15. Bedside Ultrasonography: The RUSH Protocol
16. · 5.1 · Systematic evaluation of RUSH
17. · 5.2 · Integration of transvalvular Doppler: Calculation of stroke volume
18. Initial Treatment: Respiratory Support and Fluid Infusion
19. · 6.1 · Fluid therapy: Balanced crystalloids versus $0.9\%$ saline solution
20. · 6.2 · The four phases of fluid therapy (The ROSE concept)
21. Precision pharmacological vasoactive and inotropic therapy
22. · 7.1 · Vasoactive drugs and hemodynamic profiles
23. · 7.2 · Central versus peripheral vascular access in emergencies
24. Hypovolemic and Hemorrhagic Shock damage control
25. · 8.1 · Classic ATLS classification for hemorrhage
26. · 8.2 · The "Diamond of Death" in hemorrhagic trauma
27. · 8.3 · Damage control resuscitation (DCR) and massive transfusion protocol (MTP)
28. Cardiogenic Shock and SCAI Phenotypes
29. · 9.1 · The pathophysiological feedback loop of CS
30. · 9.2 · SCAI Classification (Society for Cardiovascular Angiography and Interventions)
31. · 9.3 · Short-term Mechanical Circulatory Support (MCS)
32. Septic Shock and the Campaign to Survive Sepsis
33. · 10.1 · Immunopathology and the role of the endothelium
34. · 10.2 · First hour measures package (Surviving Sepsis Campaign 2021)
35. · 10.3 · Role of hydrocortisone in refractory septic shock
36. Anaphylactic Shock and Acute Airway Management
37. · 11.1 · Vascular and respiratory pathophysiology
38. · 11.2 · Immediate diagnostic criteria
39. · 11.3 · Stepped pharmacological management protocol
40. Neurogenic Shock and Cardiovascular Autonomic Disruption
41. · 12.1 · Pathophysiology of disruption of the sympathetic reflex arc
42. · 12.2 · Management algorithm and specific therapeutic objectives
43. Obstructive Shock: Massive PE, Tamponade and Tension Pneumothorax
44. · 13.1 · Massive Pulmonary Thromboembolism (MTE)
45. · 13.2 · Acute cardiac tamponade
46. · 13.3 · Tension Pneumothorax
47. Multiorgan Dysfunction Syndrome and induced tissue damage
48. · 14.1 · Disseminated intravascular coagulation syndrome (DIC)
49. Palliative Care and Considerations in Special Populations
50. · 15.1 · The geriatric patient: Masking of the response to shock
51. · 15.2 · The obstetric patient: Physiological changes during pregnancy
52. · 15.3 · The pediatric patient: Cardiac reserve dependent on HR
53. Post-Resuscitation, De-escalation and Diagnostic Integration Protocol
54. · 16.1 · De-escalation of vasoactive drugs and fluid therapy
55. · 16.2 · Integrated decision-making algorithm in shock
56. · 16.3 · Essential principles for the clinician in the management of shock