Pathophysiology, Diagnosis and Comprehensive Management of Shock | Emergency and Critical Care Medicine

Emergency Room · Clinical Specialties

How it begins

Un análisis exhaustivo del estado de hipoperfusión tisular sistémica. Desde el daño mitocondrial microcirculatorio hasta las guías contemporáneas de reanimación y soporte vasopresor multimodal en el paciente crítico.

What it covers

1. Pathophysiology and Comprehensive Management of Shock
2. Cellular Physiopathology, Microcirculation and Bioenergetic Dysoxia
3. · 1.1 · Fundamental equations of oxygen transport ($DO_2$ and $VO_2$)
4. · 1.2 · Microcirculation and glycocalyx dysfunction
5. · 1.3 · Biochemistry of cellular hypoxia and lactate type A vs Type B
6. Classification and Specific Pathophysiology of Shock Phenotypes
7. · 2.1 · Neuroendocrine compensation mechanisms (Compensated phase)
8. · 2.2 · Loss of compensation and refractory vasoplegia
9. Clinical Evaluation, Tissue Perfusion and Biomarkers
10. · 3.1 · The three windows of clinical perfusion
11. · 3.2 · Metabolic parameters and their prognostic value
12. Advanced Hemodynamic Monitoring and interactivity
13. · 4.1 · Dynamic evaluation of response to fluids (Fluid responsiveness)
14. · 4.2 · Pulmonary Artery Catheter (Swan-Ganz) and Transpulmonary Thermodilution (PiCCO)
15. Bedside Ultrasonography: The RUSH Protocol
16. · 5.1 · Systematic evaluation of RUSH
17. · 5.2 · Integration of transvalvular Doppler: Calculation of stroke volume
18. Initial Treatment: Respiratory Support and Fluid Infusion
19. · 6.1 · Fluid therapy: Balanced crystalloids versus $0.9\%$ saline solution
20. · 6.2 · The four phases of fluid therapy (The ROSE concept)
21. Precision pharmacological vasoactive and inotropic therapy
22. · 7.1 · Vasoactive drugs and hemodynamic profiles
23. · 7.2 · Central versus peripheral vascular access in emergencies
24. Hypovolemic and Hemorrhagic Shock damage control
25. · 8.1 · Classic ATLS classification for hemorrhage
26. · 8.2 · The "Diamond of Death" in hemorrhagic trauma
27. · 8.3 · Damage control resuscitation (DCR) and massive transfusion protocol (MTP)
28. Cardiogenic Shock and SCAI Phenotypes
29. · 9.1 · The pathophysiological feedback loop of CS
30. · 9.2 · SCAI Classification (Society for Cardiovascular Angiography and Interventions)
31. · 9.3 · Short-term Mechanical Circulatory Support (MCS)
32. Septic Shock and the Campaign to Survive Sepsis
33. · 10.1 · Immunopathology and the role of the endothelium
34. · 10.2 · First hour measures package (Surviving Sepsis Campaign 2021)
35. · 10.3 · Role of hydrocortisone in refractory septic shock
36. Anaphylactic Shock and Acute Airway Management
37. · 11.1 · Vascular and respiratory pathophysiology
38. · 11.2 · Immediate diagnostic criteria
39. · 11.3 · Stepped pharmacological management protocol
40. Neurogenic Shock and Cardiovascular Autonomic Disruption
41. · 12.1 · Pathophysiology of disruption of the sympathetic reflex arc
42. · 12.2 · Management algorithm and specific therapeutic objectives
43. Obstructive Shock: Massive PE, Tamponade and Tension Pneumothorax
44. · 13.1 · Massive Pulmonary Thromboembolism (MTE)
45. · 13.2 · Acute cardiac tamponade
46. · 13.3 · Tension Pneumothorax
47. Multiorgan Dysfunction Syndrome and induced tissue damage
48. · 14.1 · Disseminated intravascular coagulation syndrome (DIC)
49. Palliative Care and Considerations in Special Populations
50. · 15.1 · The geriatric patient: Masking of the response to shock
51. · 15.2 · The obstetric patient: Physiological changes during pregnancy
52. · 15.3 · The pediatric patient: Cardiac reserve dependent on HR
53. Post-Resuscitation, De-escalation and Diagnostic Integration Protocol
54. · 16.1 · De-escalation of vasoactive drugs and fluid therapy
55. · 16.2 · Integrated decision-making algorithm in shock
56. · 16.3 · Essential principles for the clinician in the management of shock