The History and Evolution of Circulatory Shock

Hypoxic hepatitis in critically ill patients: incidence, etiology and risk factors for mortality

“…Shock was defined as persistent arterial hypotension and inadequate tissue perfusion in the setting of sepsis (septic shock), trauma or hemorrhage (traumatic or hemorrhagic shock), or extracardiac obstruction (obstructive shock) that required vasopressors to revert hypotension [17,18]. Hypotension was defined by a persistent systolic arterial pressure below 90 mmHg, a mean arterial pressure below 60 mmHg, or a reduction in systolic blood pressure of [40 mmHg from baseline.…”

Validating a pragmatic definition of shock in adult patients presenting to the ED

“…However, for the purposes of this article, hypotension was defined as either SBP b90 mm Hg or MAP b 65 mm Hg. Metabolic acidosis was defined as either a lactate ≥ 4 mmol/L or a base deficit ≤−5 mmol/L [19][20][21]. We have used the term cryptic shock for those cases with probable global tissue hypoperfusion but with a SBP ≥ 90 mm Hg.…”

“…This definition is also based on practicality, previously published work, and the opinion of experienced clinicians. It uses clinical and point-of-care investigations, which are readily available in modern EDs [10,11,18,19]. The primary aim of this study was to validate the a priori definition of shock against 28-day mortality.…”

Pediatric Shock: An Overview

“…It was actually the English physician Clarke's mistranslation of LeDran's work in 1743 that first introduced the term into the English language to describe the sudden deterioration of a *Address correspondence to this author at the University of Cincinnati College of Medicine, Clinical Director, Division of Critical Care Medicine, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH 45229-3039, USA; Tel: (513) 636-4259; Fax: (513) 636-4267; E-mail: Derek.wheeler@cchmc.org patient's condition following major trauma [13]. Consistent with these early descriptions was the widespread belief that the pathologic state of shock was due to a nervous condition [14]. For example, the British surgeon Benjamin Travers described shock as a functional concussion by which the influence of the brain over the organ of circulation is deranged or suspended in 1826 [15].…”

“…Most physicians believed that the nerves were the only anatomic structures found throughout the body -thus, only a condition affecting the nerves could have such widespread effects on the body and explain the wide range of clinical signs and symptoms associated with the shock state. This was the prevailing theory until the time of World War I and led to the widespread use of stimulants, depressants, or in some cases, electrical shock for treating patients with shock [14].…”