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403 Possible Causes for Refractory Shock

  • Adrenal Insufficiency

    shock, poor response to inotropes/pressors fever confusion CHRONIC ADRENAL INSUFFICIENCY GENERAL: weight loss, arthalgia, myalgia CNS: fatigue, anorexia, mood change CVS:[lifeinthefastlane.com] Patients with septic shock who are pressor dependent or refractory to fluid resuscitation may receive a short course of hydrocortisone regardless of their serum cortisol levels[ncbi.nlm.nih.gov] […] suppression - adrenal atrophy ADRENAL CRISIS concurrent illness, surgery, failure to take medications GI: abdominal pain, vomiting and diarrhoea CVS: dehydration, hypotension, refractory[lifeinthefastlane.com]

  • Toxic Shock Syndrome

    Despite conventional treatment, the patient developed refractory shock, which was immediately improved with PMX-DHP.[ncbi.nlm.nih.gov] shock.[ncbi.nlm.nih.gov] It is possible that an elevated shock index could be an early sign of hemodynamic instability, particularly if this is refractory to volume resuscitation. 0 Clinical Presentation[emcrit.org]

  • Meningococcemia

    She developed a severe refractory septic shock with disseminated intravascular coagulation and rhabdomyolysis.[pediatrics.aappublications.org] "Central extracorporeal membrane oxygenation for refractory pediatric septic shock". Pediatr Crit Care Med. vol. 12. 2011 Mar. pp. 133-6.[clinicaladvisor.com] Plasmapheresis, hemofiltration, extra corporeal membrane oxygenation (ECMO): For patients with severe or refractory septic shock, alternative therapies including plasmapheresis[clinicaladvisor.com]

  • Acute Peritonitis

    […] septic shock.[uspharmacist.com] Later manifestations include cool, clammy, pale skin and cyanosis as shock becomes refractory. Monitor urine output.[nurseslabs.com] […] inotropic therapy can be added on to patients with cardiac dysfunction. 5 Continuous hydrocortisone infusion totaling 200 mg/24 hours is recommended for those with vasopressor-refractory[uspharmacist.com]

  • Hantavirus Pulmonary Syndrome

    shock despite fluid resuscitation, and vasoactive medications.[ncbi.nlm.nih.gov] In 1998, Crowley and colleagues [6] identified several criteria for non-survival, which include: refractory shock, lactate concentration 4.0 mmol l 1 , severe hypoxia ( Pa[academic.oup.com] ; b) serum lactate concentration of 4.0 mmol/L (normal range 0.0 to 2.2); c) pulseless electrical activity or ventricular fibrillation or ventricular tachycardia; and d) refractory[ncbi.nlm.nih.gov]

  • Flecainide

    Venoarterial extracorporeal membrane oxygenation should be strongly considered for refractory shock and/or cardiac arrest secondary to flecainide toxicity.[ncbi.nlm.nih.gov]

  • Acute Iron Intoxication

    A 24 y/o male, after attempting suicide by ingesting liquid ferric chloride, presented with protracted vomiting and epigastric pain. He was noted to have leukocytosis, a metabolic acidosis and an elevated serum iron level. Hemorrhagic gastritis, coagulation defects and an increase in urine beta 2-microglobulin, indicating[…][ncbi.nlm.nih.gov]

  • Chest Trauma

    After 2 days, the patient died due to refractory cardiogenic shock.[ncbi.nlm.nih.gov]

  • Retroperitoneal Hemorrhage

    The primary endpoint trended higher in patients presenting with refractory shock; however, this difference was not statistically significant.[ncbi.nlm.nih.gov] We identified three groups with RPH for comparison: patients who developed refractory shock (systolic blood pressure 80 mm Hg for 30 min despite fluids and vasopressors, n[ncbi.nlm.nih.gov] Patients who developed refractory shock had significantly more bleeding quantified by abdominal/pelvic CT (P 0.001), had a higher rate and amount of red blood cell transfusion[ncbi.nlm.nih.gov]

  • Basilar Artery Occlusion

    Despite aggressive surgery, sepsis persisted, and therapy was limited by uncontrollable coagulopathy and catecholamine refractory shock after 15 days.[ncbi.nlm.nih.gov]

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