Progressive stage If the cause of shock is not corrected the patient moved into the progressive stage this is where compensatory effects have failed.
Signs and symptoms
Neurologically- Delirum, decreased cerebral perfusion, response, BF.
Cardiovascular- Increased cellular permeability resulting in oedema, decreased CO, BP with increased HR. MAP <60. Decrease perfusion resulting in ischemia, arrhythmia, MI. Drop in CR.
Resp system- Acute respiratory distress system- increase capillary permeability, tachypnoea, moist crackles, decreased compliance, pulmonary odeama.
GI- Decrease perfusion and vasoconstriction, ischaemia, GI bleeding, impaired absorption of nutrients.
Renal- ischemia, decreasd urine, osmolity, potassium, increased BUN creatine ratio, sodium. Metabolic acidosis.
Hepatic system- Failure to metabolise drugs and waste, cell death, jaundice, increased lactate and NH3
Haematological- Thrombin clot, consumption of platelets and clotting factors.
Hypo/hyperthemia, cold and clammy