CIRCULATORY FAILURE •The main function of circulation is keep a good organ and tissue perfusion • • BP = CO x TPR •Circulatory failure is a generalized inadequate blood flow in the body that causes tissue damage due to reduced blood flow - reduced transport of oxygen (and other nutritional factors). The cardiovascular system itself (cardiac muscle, vascular walls, vasomotor system, and other parts of circulation) worsens when coming „circulatory shock“ CIRCULATORY FAILURE • BP = CO x TPR •CO decrease: ülower volume in circulation – lower venous return •decrease of filling pressure and by Frank- Starling principle decrease of CO •Clinical: e.g. hemorrhagic shock, hypovolemic shock •Therapy: infusion (e.g. of physiological solution) CIRCULATORY FAILURE • BP = CO x TPR •CO decrease: üvasodilatation of venous system - sudden periphery vasodilatation – e.g. sudden loss of vasomotor tone : vasomotor syncope (neurogenic shock-brain damage, deep anesthesia) üemotional activation of parasympathetic signals to slow the heart and also activation of inverse sympathetic signals to dilate the peripheral vasculature : vasovagal syncope (emotional disturbance-fainting in young people) CIRCULATORY FAILURE • BP = CO x TPR •CO decrease: ülower pumping function of the heart •e.g. myocardial infarction, severe dysfunction of the heart valves, cardiac arrhythmias •Result: cardiogenic shock •= circulatory shock, which results from the weakened ability of the heart as a pump; (85% of people who develop a cardiogenic shock will not survive) CIRCULATORY FAILURE •BP = CO x TPR •Circulatory shock without the change of CO •Abnormal increase in metabolic demands of the organism (so great that physiological CO is insufficient) •Abnormal tissue perfusion – e.g. septic shock (blood poisoning) •(inadequate supply of nutrients or inadequate production of waste substances from tissues) • CIRCULATORY FAILURE • BP = CO x TPR •TPR decrease: ütoxic vasodilatation (by histamin-allergy) – anaphylactic shock - sting by a bee ü üDysbalance of autonomy nervous system – sympathetic part – decrease of sympathetic tone of vessels vegetative collapse - dysbalance of the autonomic nervous system (decrease in the influence of sympathetic to the vascular tone – everything is related to the situations described in vasodilation of the venous system) ü ü NYHA classification Clipboard07.bmp •SYNCOPE - a manifestation of brain ischemia that arises with a sudden drop in blood pressure due to failure in circulation - if the lying - consciousness returns quickly - within one minute • Syncope is defined as a transient loss of consciousness due to cerebral hypoperfusion, characterized by a rapid onset, short duration, and spontaneous complete recovery •If the pressure drops for several hours, they are metabolic changes in the ischemic organs and developing „a shock“ •SHOCK = is acute circulatory insufficiency syndrome with manifestations of tissue ischemia in a different areas of the body