Home > Medical Reference > Complementary Medicine

Shock


Shock occurs when your blood pressure falls to a very low level. As your blood pressure falls, your brain and other organs don't get enough blood or oxygen to function, and they begin to fail. Shock can arise from any of a number of causes. It is a life-threatening medical emergency and must be treated early to avoid serious complications and even death.


Signs and Symptoms

Common signs and symptoms of shock include the following:


What Causes It?

Shock can have several causes. Doctors classify shock according to four categories:

Loss of fluid in the bloodstream (hypovolemic shock) -- occurs after heavy bleeding from an injury or a condition such as bleeding ulcers. Hypovolemic shock can also occur if your body loses too much fluids other than blood (such as losing water after severe diarrhea or vomiting, or losing plasma after serious burns).

Blood vessels become too dilated (distributive shock) -- If the blood vessels expand too much, they are not able to keep blood circulating to all organs. Septic shock, which occurs when bacteria invade the bloodstream, and anaphylactic shock, which is a severe allergic reaction, are examples.

Heart problems (cardiogenic shock) -- In this case, the heart doesn't pump enough blood through the body. It can be caused by a heart attack, abnormal heart rhythm, or damage to the heart from heart disease.


Who's Most At Risk?

The following conditions and characteristics increase the risk for shock:


What to Expect at Your Provider's Office

Shock is an emergency and requires immediate conventional treatment. Your health care provider will diagnose shock based on your symptoms and any information about underlying disease or recent injury. Your health care provider will check blood pressure, assess mental status (memory, orientation, and alertness), measure urine output, and order blood tests to check heart, lung, and kidney function and search for evidence of sepsis (blood infection). Imaging and other procedures -- such as x-ray, electrocardiography (ECG), echocardiography -- may be performed to check the heart.


Treatment Options

Prevention

If you have heart disease or another condition that makes you susceptible to shock, you should make sure you are treated for that condition. If you have severe allergies, avoid substances that may trigger anaphylactic shock and carry self-injectable epinephrine to treat anaphylaxis.

Treatment Plan

The main goals of treatment are to maintain blood pressure and to make sure the person's vital organs get enough blood and oxygen. First aid for shock includes having the person lie on their back, raising their legs to help blood return to the heart, stopping any bleeding, covering them with a coat or blanket to ensure warmth, and performing cardiopulmonary resuscitation (CPR), if needed. Emergency medical staff will administer oxygen and, in the case of hypovolemic and septic shock, intravenous fluids.

Drug Therapies

The following medications may be used to treat shock:

Complementary and Alternative Therapies

Shock is always life-threatening and requires emergency conventional medical care. Some complementary and alternative therapies, however, may be used along with conventional treatment, after a person's condition stabilizes to help prevent shock. For instance, certain nutrients may help protect against the harmful effects of shock and improve the outcome of conventional treatment.

Nutrition and Supplements

Oxidative stress (damage to cells caused by the body's normal use of oxygen) may play a role in shock. Several studies have suggested treatment with antioxidants that help rid the body of free radicals (harmful byproducts of the oxidative process) may protect against some types of shock. However, most of these have been animal studies. It is not known whether or not these supplements will also benefit humans.

Herbs

As noted, shock always requires emergency conventional medical treatment and should never be treated with herbs alone. Some herbs that support the immune system may be beneficial in treating septic shock, along with conventional medications. Talk to your doctor before taking any herbs to treat or prevent shock.

An Ayurvedic formula containing the following herbs helped reduce bacteria levels in the blood of rats infected with Escherichia coli (an infection that can spread to the bloodstream, potentially causing septic shock):

Several newly developed herbal remedies based on traditional Chinese medicine were evaluated for use in 183 people with septic shock. Injections of the following herbs appeared to increase blood circulation as well as lower the death rate significantly in the treatment group:

Two herbs that have been used traditionally to treat shock are aconite (Aconitum napellus), a highly toxic herb that should only be used with a doctor's supervision, and ginseng (Panax ginseng).

Homeopathy

Scientific studies of homeopathic remedies for the treatment of shock specifically have not been conducted. The remedy Aconite , however, is often used by homeopathic doctors for emergency conditions. In homeopathic remedies, aconite is highly diluted, and only a trace amount of the herb is present, so it is not toxic in a homeopathic formulation.


Prognosis/Possible Complications

If someone suffering from shock receives immediate treatment, the prognosis is good. Immediate treatment for anaphylactic shock, for example, usually results in complete recovery. But any case of shock is life-threatening, regardless of its cause, particularly in the elderly. Shock often causes organ damage (including the kidneys, brain, and liver), cardiac arrest, and respiratory failure.


Following Up

If you are suffering from shock, you will likely be admitted to intensive care. Following treatment, your health care provider will carefully monitor your condition, including temperature, blood pressure, cardiac function, urine flow, and blood chemistry.


Supporting Research

Beers MH, Porter RS, et al. The Merck Manual of Diagnosis and Therapy. 18th ed. Whitehouse Station, NJ: Merck Research Laboratories; 2006:559-564.

Corbucci GG, Loche F. L-carnitine in cardiogenic shock therapy: pharmacodynamic aspects and clinical data. Int J Clin Pharmacol Res. 1993;13(2):87-91.

De la Fuente M, Victor VM. Anti-oxidants as modulators of immune function. Immunol Cell Biol . 2000;78(1):49-54.

Farolan LR, Goto M, Myers TF, Anderson CL, Zeller WP. Perinatal nutrition enriched with omega-3 polyunsaturated fatty acids attenuates endotoxic shock in newborn rats. Shock. 1996;6(4):263-266.

Felbinger TW, Suchner U, Goetz AE. Treating patients with severe sepsis [letter]. N Engl J Med. 1999;341(1):56-57.

Gasparetto A, Corbucci GG, De Blasi RA, et al. Influence of acetyl-L-carnitine infusion on haemodynamic parameters and survival of circulatory-shock patients. Int J Clin Pharmacol Res . 1991;11(2):83-92.

Greenberg SS, Xie J, Zatarain JM, Kapusta DR, Miller MJ. Hydroxocobalamin (vitamin B 12a ) prevents and reverses endotoxin-induced hypotension and mortality in rodents: role of nitric oxide. J Pharmacol Exp Ther . 1995;273(1):257-65.

Hochman JS, Sleeper LA, Webb JG, et al. Early revascularization in acute myocardial infarction complicated by cardiogenic shock. N Engl J Med . 1999;341(9):625-34.

Jack RA. Aconite -- the number one shock and fever medicine. Hahnemannian . 1986;121(3):5-6.

Jin MW, Zhou ZY, Zhang SW. Study on treatment of infectious shock with recipe of liqi huoxue and kaibi gutuo [in Chinese]. Chung Kuo Chung Hsi I Chieh Ho Tsa Chih. 1995;15(10):589-592.

LeClaire RD, Kell W, Bavari S, Smith TJ, Hunt RE. Protective effects of niacinamide in staphylococcal enterotoxin-B-induced toxicity. Toxicology . 1996;107(1):69-81.

Lelli JL, Drongowski RA, Gastman B, Remick DG, Coran AG. Effects of Coenzyme Q10 on the mediator cascade of sepsis . Circ Shock . 1993;39(3):178-187.

Liu YY. Comparison between the therapeutic effects of ginseng-aconitum-bupleurum injection and dexamethasone on septic shock complicated with disseminated intravascular coagulation induced by E. coli in dogs. Zhong Xi Yi Jie He Za Zhi. 1990 Nov;10(11):675-6, 645.

Mendez C, Jurkovich GJ, Wener MH, Garcia I, Mays M, Maier RV. Effects of supplemental dietary arginine, canola oil, and trace elements on cellular immune function in critically injured patients. Shock. 1996;6(1):7-12.

Mitra SK, Gupta M, Suryanarayana T, Sarma DN. Immunoprotective effect of IM-133. Int J Immunopharmacol . 1999;21(2):115-120.

Victor VV, Guayerbas N, Puerto M, Medina S, De la Fuente M. Ascorbic acid modulates in vitro the function of macrophages from mice with endotoxic shock. Immunopharmacology . 2000;46(1):89-101.

Weimann A, Bastian L, Bischoff WE, et al. Influence of arginine, omega-3 fatty acids and nucleotide-supplemented enteral support on systemic inflammatory response syndrome and multiple organ failure in patients after severe trauma. Nutrition. 1998;14(2):165-172.

Winter BK, Fiskum G, Gallo LL. Effects of L-carnitine on serum triglyceride and cytokine levels in rat models of cachexia and septic shock. Br J Cancer. 1995;72(5):1173-1179.

Yamada M. Effects of coenzyme Q10 in hemorrhagic shock. Crit Care Med. 1990;18(5):509-514.

Zingarelli B, Salzman AL, Szabo C. Protective effects of nicotinamide against nitric oxide-mediated delayed vascular failure in endotoxic shock: potential involvement of polyADP ribosyl synthetase. Shock . 1996;5(4):258-264.


A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org). URAC's accreditation program is the first of its kind, requiring compliance with 53 standards of quality and accountability, verified by independent audit. A.D.A.M. is among the first to achieve this important distinction for online health information and services. Learn more about A.D.A.M.'s editorial process . A.D.A.M. is also a founding member of Hi-Ethics (www.hiethics.com) and subscribes to the principles of the Health on the Net Foundation (www.hon.ch).

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997-2007 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
adam.com