Wstrząs Artykuł przeglądowy


Mariola Laszuk
Maria Różańska
Dariusz A. Kosior
Olga Możeńska


W artykule zostały przedstawione aktualna definicja, patomechanizmy oraz najczęstsze postacie kliniczne wstrząsu. Ponadto opisano, jak zgodnie z najnowszą wiedzą powinny wyglądać postępowanie terapeutyczne oraz resuscytacja chorego we wstrząsie. Dodatkowo przedstawiono pomiary, jakie można wykonać w tej grupie chorych w celu poprawy skuteczności monitorowania i leczenia.


Dane pobrania nie są jeszcze dostepne


Jak cytować
Laszuk , M., Różańska , M., Kosior , D. A., & Możeńska , O. (2015). Wstrząs . Kardiologia W Praktyce, 9(1), 40-46. Pobrano z


1. Sakr Y., Reinhart K., Vincent J.L. et al.: Does dopamine administration in shock influence outcome? Results of the Sepsis Occurrence in Acutely Ill Patients (SOAP) Study. Crit. Care Med. 2006; 34(3): 589-597.
2. Vincent J.L., Ince C., Bakker J.: Clinical review: Circulatory shock – an update: a tribute to Professor Max Harry Weil. Crit Care 2012; 16(6): 239.
3. Weil M.H., Shubin H.: Proposed reclassification of shock states with special reference to distributive defects. Adv. Exp. Med. Biol. 1971; 23(0): 13-23.
4. De Backer D., Biston P., Devriendt J. et al.: Comparison of dopamine and norepinephrine in the treatment of shock. N. Engl. J. Med. 2010; 362(9): 779-789.
5. Labovitz A.J., Noble V.E., Bierig M. et al.: Focused cardiac ultrasound in the emergent setting: a consensus statement of the American Society of Echocardiography and American College of Emergency Physicians. J. Am. Soc. Echocardiogr. 2010; 23(12): 1225-1230.
6. Vincent J.L., Rhodes A., Perel A. et al.: Clinical review: Update on hemodynamic monitoring – a consensus of 16. Crit. Care 2011; 15(4): 229.
7. Weil M.H., Shubin H.: The “VIP” approach to the bedside management of shock. JAMA 1969; 207(2): 337-340.
8. Marik P.E., Cavallazzi R., Vasu T. et al.: Dynamic changes in arterial waveform derived variables and fluid responsiveness in mechanically ventilated patients: a systematic review of the literature. Crit. Care Med. 2009; 37(9): 2642-2647.
9. Vincent J.L., Weil M.H.: Fluid challenge revisited. Crit. Care Med. 2006; 34(5): 1333-1337.
10. Delaney A.P., Dan A., McCaffrey J. et al.: The role of albumin as a resuscitation fluid for patients with sepsis: a systematic review and meta-analysis. Crit. Care Med. 2011; 39(2): 386-391.
11. Dellinger, R.P., Levy M.M., Rhodes A. et al.: Surviving Sepsis Campaign: international guidelines for management of severe sepsis and septic shock, 2012. Intensive Care Med. 2013; 39(2): 165-228.
12. Bellomo R., Chapman M., Finfer S. et al.: Low-dose dopamine in patients with early renal dysfunction: a placebo-controlled randomised trial. Australian and New Zealand Intensive Care Society (ANZICS) Clinical Trials Group. Lancet 2000; 356(9248): 2139-2143.
13. De Backer D., Biston P., Devriendt J. et al.: Dopamine versus norepinephrine in the treatment of septic shock: a meta-analysis. Crit. Care Med. 2012; 40(3): 725-730.
14. Annane D., Vignon P., Renault A. et al.: Norepinephrine plus dobutamine versus epinephrine alone for management of septic shock: a randomised trial. Lancet 2007; 370(9588): 676-684.
15. Levy B., Bollaert P.E., Charpentier C. et al.: Comparison of norepinephrine-dobutamine to epinephrine for hemodynamics, lactate metabolism, and organ function variables in cardiogenic shock. A prospective, randomized pilot study. Crit. Care Med. 2011; 39(3): 450-455.
16. Myburgh J.A., Higgins A., Jovanovska A. et al.; CAT Study investigators: A comparison of epinephrine and norepinephrine in critically ill patients. Intensive Care Med. 2008; 34(12): 2226-2234.
17. Alexander J.H., Reynolds H.R., Stebbins A.L.; TRIUMPH Investigators: Effect of tilarginine acetate in patients with acute myocardial infarction and cardiogenic shock: the TRIUMPH randomized controlled trial. JAMA 2007; 297(15): 1657-1666.
18. López A., Lorente J.A., Steingrub J. et al.: Multiple-center, randomized, placebo-controlled, double-blind study of the nitric oxide synthase inhibitor 546C88: effect on survival in patients with septic shock. Crit. Care Med. 2004; 32(1): 21-30.
19. Russell J.A., Walley K.R., Singer J. et al.: Vasopressin versus norepinephrine infusion in patients with septic shock. N. Engl. J. Med. 2008; 358(9): 877-887.
20. Russell J.A., Walley K.R., Gordon A.C. et al.: Interaction of vasopressin infusion, corticosteroid treatment, and mortality of septic shock. Crit. Care Med. 2009; 37(3): 811-818.
21. De Backer D., Creteur J., Dubois M.J. et al.: The effects of dobutamine on microcirculatory alterations in patients with septic shock are independent of its systemic effects. Crit. Care Med. 2006; 34(2): 403-408.
22. Jansen T.C., van Bommel J., Schoonderbeek F.J. et al.: Early lactate-guided therapy in intensive care unit patients: a multicenter, open-label, randomized controlled trial. Am. J. Respir. Crit. Care Med. 2010; 182(6): 752-761.
23. Thiele H., Zeymer U., Neumann F.J. et al.: Intraaortic balloon support for myocardial infarction with cardiogenic shock. N. Engl. Med. 2012; 367(14): 1287-1296.
24. Combes A., Costa M.A., Trouillet J.L. et al.: Outcomes and long-term quality-of-life of patients supported by extracorporeal membrane oxygenation for refractory cardiogenic shock. Crit. Care Med. 2008; 36(5): 1404-1411.
25. Vincent J.L.: Understanding cardiac output. Crit. Care 2008; 12(4): 174.
26. Rivers E., Nguyen B., Havstad S. et al.: Early goal-directed therapy in the treatment of severe sepsis and septic shock. N. Engl. J. Med. 2001; 345(19): 1368-1377.
27. Vincent J.L., Dufaye P., Berre J. et al.: Serial lactate determinations during circulatory shock. Crit. Care Med. 1983; 11(6): 449-451.
28. De Backer D., Hollenberg S., Boerma C. et al.: How to evaluate the microcirculation: report of a round table conference. Crit. Care 2007; 11(5): R101.
29. Sakr Y., Dubois M.J., De Backer D. et al.: Persistent microcirculatory alterations are associated with organ failure and death in patients with septic shock. Crit. Care Med. 2004; 32(9): 1825-1831.
30. Gomez H., Torres A., Polanco P. et al.: Use of non-invasive NIRS during a vascular occlusion test to assess dynamic tissue O(2) saturation response. Intensive Care Med. 2008; 34(9): 1600-1607.
31. Creteur J., Carollo T., Soldati G. et al.: The prognostic value of muscle StO2 in septic patients. Intensive Care Med. 2007; 33(9): 1549-1556.
32. Rivers E.P., Kruse J.A., Jacobsen G. et al.: The influence of early hemodynamic optimization on biomarker patterns of severe sepsis and septic shock. Crit. Care Med. 2007; 35(9): 2016-2024.
33. Correa T.D., Vuda M., Blaser A.R. et al.: Effect of treatment delay on disease severity and need for resuscitation in porcine fecal peritonitis. Crit. Care Med. 2012; 40(10): 2841-2849.