Medical Critical Care

Medical critical care, also called Intensive care medicine, is a medical specialty that deals with critically ill patients who have, are at risk of, or are recovering from conditions that may be life-threatening.

Overview - Medical Critical Care

Majority of patients in medical critical care unit are of sepsis and septic shock with multiorgan failure.

Even today septic shock has mortality around 50%. Hypovolemia shock following major bleeding and major dehydration requires ICU care.

India being tropical country complicated malaria, dengue, typhoid, rickettsia infection, leptospirosis are very common and major cause of mortality.

Different Types of Shocks

Vasodilatory Shock

Septic Shock
Anaphylactic Shock
Secondary to Allergy
Anaphylaxis

Obstructive Shock

Causes are: Pulmonary Embolism & Cardiac Temponad Pulmonary Embolism Due to thrombus in pulmonary artery caused due to hypercoagulable state due to underling medical condition like:

Hyper Homocysteinemia
Prolonged Imobilization
SLC, ANA, APLA, Anticardiolipin Antibody, Lupus Anticoagulant, Protein C&S
Post Op-Orthopedic Surgery
Maligancy
Pregnancy
Familial Disorder

Cardiac Temponand – Fluid in pericardial cavity – Presented with hypotension, chest pain – When patient has severe shock, may require pericardiocentesis

Hypovolemic Shock

Due to age fluid loss in, dehydration due to haemorrhage secondary to RTA, post-operative setting and post-partum.

Cardiogenic Shock

Secondary to severe LVD due to major myocardial infarction
Severe case require intra aortic balloon pump insertion
Urgent revascularization by percutaneous coronary intervention

Septic Shock – Vasodilatory Shock

In severe sepsis vasodilatation due to endotoxin released in systemic circulation.

FAQs & Info

What is shock?

Defined as poor organ perfusion, systolic blood pressure less than 90 mm hg. Despite adequate fluid resuscitation.

Is multi organ failure reversible?

Multi organ failure is reversible, requires tertiary care, ICU, competent critical care team.

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