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Shock, sepsis and SIRS

image of Shock, sepsis and SIRS
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Abstract

Shock is a syndrome that results from inadequate cellular energy production. This arises from an imbalance between oxygen delivery (DO2) and oxygen consumption (VO2), and a transition from efficient aerobic to inefficient anaerobic cellular metabolism. Anaerobic metabolism provides a temporary fix for inadequate cellular energy production, but results in lactate accumulation and metabolic acidosis. This chapter focusses on Definitions; Overview and pathophysiology; Clinical recognition of shock, sepsis and SIRS; Therapy and monitoring response to therapy; and Prognosis.

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Figures

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11.1 The delivery of oxygen to tissues (O) is dependent on cardiac output and the oxygen content of arterial blood ( O).
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11.5 Hypotension leads to activation of the renin–angiotensin–aldosterone system (RAAS).
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11.8 A dog with hypovolaemic shock secondary to a spontaneous haemoabdomen. The dog is severely depressed, tachycardic, has pale mucous membranes and weak pulses.
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11.9 Blood products may be necessary to stabilize animals with haemorrhagic shock.
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11.10 The dog in Figure 11.8 following fluid resuscitation with intravenous isotonic crystalloids. Mentation has improved, heart rate is normal, pulses are stronger and mucous membranes are pink.
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11.14 A source of infection in the septic patient should be readily identified and treated. In this example, mastitis has progressed to signs of septic shock.
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11.15 Haemodynamic support, infection control, metabolic care and supportive care are essential in this postoperative cat with septic shock secondary to septic peritonitis.

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