SHOCK

CARDIOGENIC
HYPOVOLEMIC
NEUROGENIC
SEPTIC

Arni Pahlawani Amir/11120172105 TUTOR: dr. Sumarni, Sp.JP-FIHA

WHAT IS
SHOCK

Pathophysiologically, shock is a circulatory

disorder that is interpreted as an inadequate
condition for transporting oxygen to
the tissue or perfusion caused by
hemodynamic disorders

Dwiva TR. Gambaran Pengetahuan Dokter Muda tentang Syok Hipovolemik di RSUP DR. M. Djamil Padang. Universitas Andalas; 2016.
 CARDIOGENIC
CLASIFICATION 1 SHOCK

NEUROGENIC
2 SHOCK

HYPOVULEMIC
3 SHOCK
SEPTIC
Dave S, Cho JJ. Shock, Neurogenic. 2017; 4
Setiati S, Alwi I, Simadibrata M, Setiyohodi B, Syam A, editors. Buku Ajar Ilmu Penyakit Dalam. VI. Jakarta; 2014. SHOCK
Kalil A, Pinsky M. Septic Shock. Medscape. 2019;
Kolecki P. Hypovulemic Shock. Medscape. 2016;
 ETIOLOGY of
HYPOVULEMIC
SHOCK

LOST OF
PLASMA

LOST OF
DEHIDRATION BLOOD

Setiati S, Alwi I, Simadibrata M, Setiyohodi B, Syam A, editors. Buku Ajar Ilmu Penyakit Dalam. VI. Jakarta; 2014.
Kolecki P. Hypovulemic Shock. Medscape. 2016;
 ETIOLOGY of
CARDIOGENIC
SHOCK Decreased
Increased contractility
Afterload
Valvular and Diastolic
structuralabno dysfunction
rmalities

Systolic
Arrhythmia
dysfunction

Setiati S, Alwi I, Simadibrata M, Setiyohodi B, Syam A, editors. Buku Ajar Ilmu Penyakit Dalam. VI. Jakarta; 2014.
Ren X. Cardiogenic Shock. Medscape, Dep Intern Med Univ Manitoba; Site Dir Respir Med St Boniface Gen Hosp. 2017;
 ETIOLOGY of
SEPTIC SHOCK

Infeksi Sal. Naoas

Bawah
Infeksi Sal. Cerna
ISK

Setiati S, Alwi I, Simadibrata M, Setiyohodi B, Syam A, editors. Buku Ajar Ilmu Penyakit Dalam. VI. Jakarta; 2014.
Kalil A, Pinsky M. Septic Shock. Medscape. 2019;
 Spinal injury (SCI):
motor vehicle accidents (40.4%);
fall (27.9%)
interpersonal violence (especially gunshot wounds) (15.0%),
sports (8.0%), where diving is the most common cause).

ETIOLOGY of NEUROGENIC SHOCK

Other causes of spinal cord injury:
Vascular disorders
Tumor
Infection
Spondylosis
Iatrogenic injury, especially after spinal injection and
placement of an epidural catheter
Vertebral fractures secondary to osteoporosis
Developmental disorders
Dave S, Cho JJ. Shock, Neurogenic. 2017;
 S
Kortbeek JB, Al Turki SA, Ali J, Antoine JA, Bouillon B, Brasel K, et al. Advanced trauma life support, the evidence for change. J Trauma Acute Care Surg. 64(6):1638–50.
SetiawanAang, Marvella M, Putri MA, Nurul U. CLINICAL SCIENSE SESSION-SYOK DAN TERAPI CAIRAN. Bandung; 2016.

HYPOVOLEMIC SHOCK
IGN &
IMPTOMP

Kortbeek JB, Al Turki SA, Ali J, Antoine JA, Bouillon B, Brasel K, et al. Advanced trauma life support, the evidence for change. J Trauma Acute Care Surg.
64(6):1638–50. SetiawanAang, Marvella M, Putri MA, Nurul U. CLINICAL SCIENSE SESSION-SYOK DAN TERAPI CAIRAN. Bandung; 2016.
 S
CARDIOGENIC SHOCK
IGN &
IMPTOMP

systolic pressure <90 mmHg, oliguria <20-30 cc / hour.

There are no other causes of hypotension, such
as bleeding, diarrhea, vagal reactions, arrhythmias, drugs,
and dehydration. Usually the patient looks nervous, pale,
cold extremities accompanied by peripheral
cyanosis, the skin is usually moist and cold

Setiati S, Alwi I, Simadibrata M, Setiyohodi B, Syam A, editors. Buku Ajar Ilmu Penyakit Dalam. VI. Jakarta; 2014.
Douglass M, Douglass Z, Libby P, Bonow R, editors. Braunwald’s Heart Disease-Textbook of Cardiovascular Medicine. In: 10th ed. Philladelphia: Elsevier Inc.; 2015. p. 206.
S IGN &
IMPTOMP
SEPTIC SHOCK

• Temperature > 38.9 C.

• Tachycardia. Hypotension (systolic <90 mmHg)
• Petechiae, leukocytosis or leukopenia that shifts to
the left, thrombocytopenia.
• Hyperventilation with hypocapnia.
• Local symptoms such as tenderness in the abdominal,
perirectal area (focused of infection)

SetiawanAang, Marvella M, Putri MA, Nurul U. CLINICAL SCIENSE SESSION-SYOK DAN TERAPI CAIRAN. Bandung; 2016.
S IGN &
IMPTOMP
NEUROGENIC SHOCK

• Blunt cervical spine injury.

• mechanism of injury
• Ensure the order of the center line,
• lack of awareness,
• neurological deficit,
• poisoning that might be wrongly approved,
• Bradyarrhythmias, hypotension, warm skin are classic
signs associated with neurogenic shock: orthostatic
hypotension, autonomic dysreflection, temperature of
dysregulation.

Dave S, Cho JJ. Shock, Neurogenic. 2017;

 INITIAL EXAMINATION

Kortbeek JB, Al Turki SA, Ali J, Antoine JA, Bouillon B, Brasel K, et al. Advanced trauma life support, the evidence for change. J Trauma Acute Care Surg. 64(6):1638–50.
SetiawanAang, Marvella M, Putri MA, Nurul U. CLINICAL SCIENSE SESSION-SYOK DAN TERAPI CAIRAN. Bandung; 2016.
 CAUSAL THERAPHY
CARDIOGENIC

1 SHOCK

NEUROGENIC
2 SHOCK

HYPOVULEMIC
3 SHOCK
SEPTIC
Alwi L, Salim S, LTohopory RHJKD, editors. Panduan Praktis Klinis : Penatalaksanaan di Bidang Ilmu
Penyakit Dalam. I. PAPDI; 2015. 151 p.
4 SHOCK
Gorrelick P, Testai F, Hankey G, Wardlaw J. Henkey’s Clinical Neurologu. 2nd ed. CRC Press; 2015. 288-289
p.
Dave S, Cho JJ. Shock, Neurogenic. 2017;
WASSALAM
THANK
YOU