1. =休克shock---
    A clinical syndromeresults from„decrease of effective circulatory blood volume, inadequate tissue reperfusion which subsequently leads to cellular anoxia, metabolic disturbance and dysfunction.
  2. =低血容量休克Hypovolemic Shock---
    is a state of decreased effective circulatory blood volume, caused by large amount of blood or body fluid loss, inflammatory exudation, or body fluid accumulated in the cavity.
  3. 外科休克surgical Shock---
    ①Hypovolemic shock(hemorrhagic shock, traumatic shock)
    ②Distributive shock(septic shock,neurogenic shock,allergic shock)
    ③Cardiac shock
    ④Obstructive shock。
  4. -MODS---
    Multiple organ dysfunction syndrome (MODS) is the presence of altered organ function in acutely ill patients. It usually involves two or more organ systems.
  5. -SIRS---
    Systemic Inflammatory Response Syndrome, Manifested by two or more of the following conditions:
    ①Temperature> 38℃or < 36 ℃
    ②Heart rate> 90 beats/min
    ③ Respiratory rate> 20 beats/min or PaCO2< 32 mmHg
    ④WBC count> 12,000/mm3, < 4,000/mm3, or > 10% immature (band) forms。

  6. ARDS---
    refers to the syndrome of lung injury characterized by dyspnea, severe hypoxemia, decreased lung compliance, and diffuse bilateral pulmonary infiltrates。

  7. =感染性休克的治疗原则Treatment of septic shock / principles of sepsis shock treatment/休克治疗----
    ①Fluid replacement or Blood transfusion to increase Blood volume①迅速补充血容量；
    ②control the infection: Antibiotics and operation②控制感染：处理原发感染灶；应用抗菌药物；改善病人一般情况，增强抵抗力。
    ③Treat acidosis③纠正电解质和酸碱平衡紊乱；
    ④Vasoactive drugs④改善微循环,应用血管活性药；
    ⑤Dexamethasone ⑤应用糖皮质激素；
    ⑥Nutrients supply etc
    ⑦prevent DIC and MODS
    ⑧Maintaining vital organ’s function。
    ⑥监测重要脏器如心脑肾功能,防治DIC 和 MODS。

  8. 休克的治疗How is Shock therapy----
    （1）Early Goal Directive Therapy：
    ①MAP≥65mmHg
    ②Ui eO t t≥05 l/k /h
    ②Urine Output≥0.5ml/kg/hr
    ③CVP 8～12mmHg
    ④SvO2≥70%；
    （2）Treatment：
    ①Emergent therapy：Control blood loss、Ensure airway、Central line、O2 supply、Keep warm、Analgesia；
    ②Blood volume resuscitation：Rapid fluid replacement、Blood transfusion、3% NaCl solution；
    ③Management of primary diseases；
    ④Management of metabolic acidosis；
    ⑤Vasoactive drugs；Maintaining vital organ’s function：ARDS: Machinic Ventilation 、ARF: Hemodialysis；
    ⑥ Management of DIC；
    ⑦Steroids；
    ⑧Other drugs (Calcium blocker, ATP)。
  9. SIRS 的诊断Diagnosis of SIRS----
    ①Body temperature>38℃, or < 36℃
    ②Heart rate > 90 bpm
    ③Breath >20/min, or PaCO2<4.3kpa ④white="" cell="" count=""> 12×109/L, or <4 ×109="" l,="" or="" immature="" cells="">10%
  10. 感染性休克的临床表现Clinical manifestation of septic shock----
Signs Cold shock Heat shock
Consciousness agitated, apathy awaken
Skin color pallor, cyanosis pink
Skin temp wet and cold dry and warm
Capillary reperfusion time prolonged 1~2 sec
Pulse fast and feeble slow, clear
BP gap (mmHg) < 30 > 30
Urine output (per hour) < 25 mL > 30 mL

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