The Causes of Circulatory Shock Are Many

The main causes of shock include: (1) inadequate circulating volume, as occurs in hemorrhage, burns, or sepsis; (2) loss of autonomic control of the vasculature, as occurs in central nervous system (CNS) lesions; (3) impaired cardiac function; and (4) elevated peripheral demand, as occurs in sepsis. In the first case, a reduced blood volume lowers cardiac output by reducing ventricular filling pressure. In the second case, loss of vascular tone causes venous pooling and arteriolar dilation, which again reduce the ventricular filling pressure. In the third case, the heart itself is the impediment to the circulation of blood, and in these patients the filling pressure is often elevated. In the fourth case, the cardiac output and filling pressure may be normal but cannot meet the elevated requirements of the periphery.

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