| Popis: |
Hemodynamic instability as a clinical state is, for practical purposes, either perfusion failure represented by clinical features of circulatory shock and/or advanced heart failure, or simply one or more measurements which may indicate out-ofrange but not necessarily pathological values. Physical signs of acute circulatory failure constitute primary references for shock, including hypotension, abnormal heart rates, cold extremities, peripheral cyanosis and mottling together with bedside measurements of right-sided filling pressure and decreased urine flow. For the purposes of this chapter, our focus is on perfusion failure and more precisely, acute circulatory failure as a systemic complication of underlying diseases. Accordingly, a careful history, if available, is a potentially important asset. Regional perfusion failure such as mesenteric thrombosis or acute vascular obstruction of an extremity due to either arterial or venous occlusion has sometimes been regarded as “regional shock” perhaps because it may ultimately lead to systemic perfusion failure and therefore circulatory shock. |
