[Pathophysiology of hemodynamic shock (circulatory failure). Part 2]

In the second part of the review authors stress the importance of extent and duration of tissue shock hypoenergosis and body reactive capacity for the clinical outcome of the syndrome. Functional restitution, decrease of functional organ capacity, permanent absence of certain organs' function and death, represent a possible clinical status caused by and developed during the shock syndrome. Progressive pathologic alteration of tissue function and structure correlates well with the degree of tissue hypoenergosis. A short detailed description of the tissue alterations is outlined in the paper. The shock syndrome very often consists of parallel pathogenic processes which therefore can be classified as a complex pathogenic forms of the shock. A list of clinical disorders which develop due to a complex shock pathogenesis, are outlined in the paper. Tentative relative contribution of individual pathogenic processes are estimated for various diseases. Clinical symptoms and signs, as well as laboratory parameters give a valuable information which points to the level of shock development and reversibility. Correlation of clinical parameters and pathophysiologic processes are outlined. Simple predictive rules are re-discussed in the scope of underlying pathophysiology. In addition, a related hemodynamic disorders are shortly discussed in the paper.