Distributive shock

Distributive shock is a medical condition in which abnormal distribution of blood flow in the smallest blood vessels results in inadequate supply of blood to the body's tissues and organs. It is one of four categories of shock, a condition where there is not enough oxygen-carrying blood to meet the metabolic needs of the cells which make up the body's tissues and organs. Distributive shock is different from the other three categories of shock in that it occurs even though the output of the heart is at or above a normal level. The most common cause is sepsis leading to a type of distributive shock called septic shock, a condition that can be fatal. Elbers and Ince have identified five classes of abnormal microcirculatory flow in distributive shock using side stream dark field microscopy. Class I: all capillaries are stagnant when there is normal or sluggish venular flow. Class II: there are empty capillaries next to capillaries that have flowing red blood cells. Class III: there are stagnant capillaries next to capillaries with normal blood flow. Class IV: hyperdynamic flow in capillaries adjacent to capillaries that are stagnant. Class V: widespread hyperdynamic flow in the microcirculatory system. According to the cause, there are 4 types of distributive shock: Neurogenic shock: Decreased sympathetic stimulation leading to decreased vessel tone. Anaphylactic shock Septic shock Shock due to adrenal crisis In addition to sepsis, distributive shock can be caused by systemic inflammatory response syndrome (SIRS) due to conditions other than infection such as pancreatitis, burns or trauma. Other causes include, toxic shock syndrome (TSS), anaphylaxis (a sudden, severe allergic reaction), adrenal insufficiency, reactions to drugs or toxins, heavy metal poisoning, hepatic (liver) insufficiency and damage to the central nervous system. Causes of adrenal insufficiency leading to distributive shock include acute worsening of chronic adrenal insufficiency, destruction or removal of the adrenal glands, suppression of adrenal gland function due to exogenous steroids, hypopituitarism and metabolic failure of hormone production.