Physiology of blood flow and oxygen utilization by peripheral tissue in circulatory shock
Rackow, E.C.; Weil, M.H.
Clinical Chemistry 36(8 Part 2): 1544-1546
1990
ISSN/ISBN: 0009-9147 PMID: 2387064 Document Number: 356405
The primary defect that characterizes circulatory shock is acute perfusion failure, in which oxygen metabolism is critically impaired by decreased delivery of oxygen to tissues. Four categories of hemodynamic deficits are described as the basic mechanisms of circulatory shock: hypovolemia, cardiac failure, distributive deficits, and vascular obstruction. Perfusion failure can be identified by the development of lactic acidosis, because anaerobic metabolism is the consequence of the oxygen deficit during circulatory failure. Lactic acidosis at present represents the best single objective measure of the severity of shock.