TY - CHAP M1 - Book, Section TI - Chapter 11. Shock A1 - Young, William F. A2 - Stone, C. Keith A2 - Humphries, Roger L. PY - 2011 T2 - CURRENT Diagnosis & Treatment Emergency Medicine, 7e AB - Shock is a state of severe systemic reduction in tissue perfusion characterized by decreased cellular oxygen delivery and utilization as well as decreased removal of waste byproducts of metabolism. Hypotension, although common in shock, is not synonymous to shock. One can have hypotension and normal perfusion, or shock without hypotension in a patient who is usually very hypertensive. Shock is the final preterminal event in many diseases. Progressive tissue hypoxia results in loss of cellular membrane integrity, a reversion to a catabolic state of anaerobic metabolism, and a loss of energy-dependent ion pumps and chemical and electrical gradients. Mitochondrial energy production begins to fail. Multiple organ dysfunction follows localized cellular death, and organism death follows. Despite recent advances in treatment, mortality remains high: > 50% in cardiogenic shock and > 35% in septic shock. SN - PB - The McGraw-Hill Companies CY - New York, NY Y2 - 2024/03/28 UR - accessemergencymedicine.mhmedical.com/content.aspx?aid=55747657 ER -