NMS. Surgery

32

Part I ♦ Foundations

Saturation (SvO 2 )

Mixed Venous Oxygen

Low High Low Low

Cardiogenic Usually increased Usually decreased High* High Low Low Neurogenic Normal or decreased Decreased Low Low Decreased (loss of cardiac compensation) Low Obstructive Usually increased but could be decreased Decreased Usually high* High Low Low Septic Normal or high

Often high

Cardiac

Output/Index

Early Elevated Usually low Normal or low Low Low, normal, or high After fluid resuscitation (late):

Elevated or normal Normal or low Elevated Low Normal or High

Vascular

Systemic

Resistance

Left Heart Filling Pressures (CVP/PAOP)

Blood Pressure Changes

Hypovolemic Elevated First: none

Second: narrow

pulse pressure/

elevated diastolic Third: systolic hypotension

Table 1-5: Types of Shock Based on Hemodynamic Profile Analysis Type of Shock Heart Rate

*Right ventricular failure can lead to increased central venous pressure (CVP), but decreased capillary wedge pressure, pulmonary embolus, and tension pneumothorax can also lead to high CVP but low or normal pulmonary artery occlusion pressure (PAOP) pressures. In tamponade, all filling pressures are elevated.