Shock Types & Capillary Refill Time Exception
Capillary Refill Time (CRT) measures how long it takes for colour to return to an external capillary bed after being pressed, indicating peripheral circulation. A prolonged CRT (>2-3 seconds) typically suggests poor tissue perfusion, common in many forms of shock.
Analyzing Shock Types and CRT
Different types of shock affect the circulatory system uniquely, influencing CRT:
- Hypovolaemic Shock: Caused by significant fluid or blood loss. Reduced intravascular volume leads to decreased cardiac output and poor peripheral perfusion, resulting in a prolonged CRT.
- Cardiogenic Shock: Occurs when the heart fails to pump effectively. This leads to reduced cardiac output and impaired tissue perfusion, causing a prolonged CRT.
- Obstructive Shock: Caused by a blockage hindering blood flow (e.g., pulmonary embolism). This obstruction reduces cardiac output and perfusion, leading to a prolonged CRT.
- Septic Shock: Initially characterized by widespread vasodilation and often increased cardiac output (hyperdynamic state). This can maintain peripheral perfusion, resulting in a normal or even decreased CRT, unlike other shock types. While CRT may prolong later, it's not a consistent early finding as in the others.
Therefore, septic shock is the exception where capillary refill time is not consistently prolonged, especially in its early stages.
The correct answer is Option C: Septic shock
Important Questions from Types of Shock & Treatment
Which of the following are correct in respect of Systemic Inflammatory Response Syndrome (SIRS)?
1. It is caused by the release of lipopolysaccharide endotoxin from dying $E. coli$ bacteria.
2. It is same as bacteraemia.
3. It results in Multiple Organ Dysfunction Syndrome (MODS).
4. White cell counts of more than $12\times10^9$/litre are present.
Select the answer using the code given below.
Distributive shock is described by which of the following patterns of cardio- vascular responses?
1. Vasodilation
2. Reduced resistance peripheral vascular
3. Inadequate 'afterload'
4. Low cardiac output
Select the correct answer using the code given below.
- The best measure of organ perfusion and the best monitor of adequacy of shock therapy is
- The following are features of hypovolemic shock except:
- Regarding haemorrhagic shock, which one of the following statements is correct?
