Shock and resuscitation

Abstract

In 1872, Gross referred to shock as the manifestation of the rude unhinging of the machinery of life.1 We now know that shock, at its most fundamental level, represents the clinical syndrome arising as a result of inadequate tissue perfusion. The discrepancy between substrate delivery and the cellular substrate requirement leads to cellular metabolic dysfunction. Inadequate oxygen delivery is implicated as the principal defect in shock states. The clinical manifestations of shock are caused by end-organ dysfunction secondary to impaired perfusion and the body's sympathetic and neuroendocrine response to an insufficient cellular supply/demand ratio for oxygen. © 2008 Springer New York.