Hl#,
Hg
s
ft,{R
fe
WffigffireWaEGE
nft
n.{*fr=.a
2oo
*
+
tr
ffi.g_'
HEFJE#gftU
f!
FffiIff
fi
.
E1i7
+IE*t?i.
,
ftrEffi4H!)*^
'
gfEF)F#ftllH!-FE
i#,6D
hn;+'
Ep
H
#
FH
4<
+
E
20
ttF
f€,
60
+.{t
ils
?,E
A#,zkY
G#.
lt5ffi)'
680+'{t'
lifffiBE'zl<*'F-#.H'ffH "
ffiE€eF}e
gJ
IIE)A
ffi
i5
EE
€
A'ffi
F
"
-EN,
EE
{'F
H
H!
A*'
E
EE
E
#
#IJEH
1+#
-D\ftfr,
"
+++
:t#R
Mao
Jia-Ying
PROGRESS
ON
THE THEORIES
ON
SHOCK
Shock
-
clinically presents
as
pallor, cold and clammy limbs, feeble
pulse and low blood
pressure.
ln the
early stage, catecholamines secreted
increases the resistance of
peripheral
blood vessels
-
adequate blood for the
heart and
the
brain is ensured;
later,
acidic metabolites accumulate and
pe-
ripheral resistance falls followed
by a
drop
in
blood
pressure; in the terminal
and reversible stage, fluid escapes from
the
blood to the tissues and small clots
form
-
"disseminated intra-vascular co-
agulation"
occurs.
Death
is
imminent.
Shock
is
commonly due to acute
loss
of
blood
volume, from acute
bleeding,
extensive
burns,
trauma
or
even severe
dianhoea.
ln
all
these cases, the blood
volume must be
replaced at
once.
ln-
fection causing shock is usually due to
Gram negative bacteria
-
"endotoxins"
released result
in
loss
of
peripheral
resistance; allergic shock results in se-
cretion of
large
amounts of
histamine,
loss
of peripheral resistance; shock can
also be
a
result
of
severe
pain
(neurogenic shock), or can be second-
ary
to heart failure (cardiogenic shock).
Management is according to the
spe-
cific
cause.
Despite
the elucidation
of
the
mechanism
of
shock,
the
clinical
results have not been improving in par-
allel
-
more
work
is
still
required.
'fltH
(snoct)
-iilFHh+T
+M.EE
"
EFffiR_hH
F,ft,Eft
z-
"
H^H.46!FffiF*4,Bffi&
aE
.
E,€i.R7+.
fi'-Kl€*Egg
-
E
,,
-
+qF-.tft.iH+F
".f
HgenEE€
zffi"
4ttu4
fr.fr\rtr-Kip.4
,
tlffi
fr.T*Jt-,
HjF_b.&Z<trJffi
Btts
4nT/z}ffi
'
-
.
*ftfl]*>&
(-)
^.m.,Ehtrfr.,
4+fi,ffirw
(-).fEm6E4
fr,,Ed-'&
18w.fr8ffJffiffi,Ffi*.
"
-
-
+*/€
tx tz
.ffiIE'V+I
fr,ffJFffiW]Rffi}.
*,i*EF",W.rtn'ft-4
fr."
_-
E! la
E\18'V+4
fr.,W+Fqatrffi,ffi
4E
-
FIHffi4c.rtLHffi
"
E.H;R
ffi*'Wff-f;pl&ftft.f
H
"
Wfrn
fti*fr.&In
1fr"9r)J
e6!++#S
^hm4J.:4&Wh44
fr.ffiH9r
)r4!4
f;.
"
E, €&
ffi@t'w.4*fr.
,
7Eta,l
fi,ffi
r
4@F;qE-re
"
+l
