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The definition of refractory shock or vasodilatory shock varies. In 2018, the American College of Chest Physician stated that it is presents if there is an inadequate response to high-dose vasopressor therapy defined as ≥ 0.5 mg/kg/min norepinephrine-equivalent dose. [4]
Vasoconstriction is the narrowing of the blood vessels resulting from contraction of the muscular wall of the vessels, in particular the large arteries and small arterioles. The process is the opposite of vasodilation , the widening of blood vessels.
Adrenaline, also known as epinephrine, is a hormone and medication [10] [11] which is involved in regulating visceral functions (e.g., respiration). [ 10 ] [ 12 ] It appears as a white microcrystalline granule. [ 13 ]
Injuries to nerves of the lower trunk of the brachial plexus (Klumpke's paralysis) and compression of median nerve at the flexor retinaculum of the hand (Carpal Tunnel Syndrome) can cause vasomotor changes at the areas innervated by the nerves. This area of the skin will become warmer because of vasodilation (loss of vasoconstriction). [5]
Vasodilation occurs as part of the process of inflammation, which is caused by several factors including presence of a pathogen, injury to tissues or blood vessels, and immune complexes. [7] In severe cases, inflammation can lead to sepsis or distributive shock. [11] Vasodilation is also a major component of anaphylaxis. [12]
Vasodilation and vasoconstriction are complex phenomena; they are functions not merely of the fluid mechanics of pressure and tissue elasticity but also of active homeostatic regulation with hormones and cell signaling, in which the body produces endogenous vasodilators and vasoconstrictors to modify its vessels' compliance.
It is regulated by vasoconstrictors (agents that cause vasoconstriction). These can include paracrine factors (e.g., prostaglandins), a number of hormones (e.g., vasopressin and angiotensin [26]) and neurotransmitters (e.g., epinephrine) from the nervous system. Vasodilation is a similar
Shock is the state of insufficient blood flow to the tissues of the body as a result of problems with the circulatory system.Initial symptoms of shock may include weakness, tachycardia, hyperventilation, sweating, anxiety, and increased thirst. [1]