Which is NOT a feature of Neurogenic Shock?
Correct Answer: Decreased venous capacitance
Description: (C) Decreased venous capacitance > Increased cardiac index, unchanged venous capacitance is seen in neurogenic shock> Increased cardiac index, decreased venous capacitance is most commonly associated with in septic shock> Variable change in cardiac index (can increase or decrease), increased venous capacitance is most likely seen in cardiogenic shock> Variable change in cardiac index (can increase or decrease), decreased venous capacitance = septic shock# NEUROGENIC SHOCK:> Mechanism: Loss of autonomic innervation of the cardiovascular system (arterioles, venules, small veins, including heart).> Causes: Spinal cord injury Regional anaesthesia, Drugs Neurological disorders> Characterized by loss of vascular tone & reflexes.> Signs: Hypotension, Bradycardia, Accompanying Neurological deficits.> Monitor/Findings: Haemodynamic instability, Test for Bulbocavernosus reflex> Treatment: Intravenous fluids, Vasoactive medications if refractory.HEMODYNAMIC RESPONSES TO DIFFERENT TYPES OF SHOCKType of ShockCardiac IndexSVRVenous CapacitanceCVP/ PCWPSvO2Cellular/ Metabolic EffectsHypovolemic|||||EffectSeptic|||T||||CauseCardiogenic||||-||EffectNeurogenic||-||EffectThe hemodynamic responses are indicated by arrows to show an increase (|), severe increase (||), decrease (|), severe decrease (||), varied response (||), or little effect (-). CVP = central venous pressure; PCWP = pulmonary capillary wedge pressure; SvO2 = mixed venous oxygen saturation; SVR = systemic vascular resistance.
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