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Obstructive Shock 

Obstructive Shock
Chapter:
Obstructive Shock
Author(s):

Julia Sobol

, and Jack Louro

DOI:
10.1093/med/9780190226459.003.0012
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date: 27 February 2020

In the perioperative period, various mechanisms can lead to the development of shock. The type of shock needs to be rapidly elucidated and initial management steps initiated to minimize the time of tissue hypoperfusion. Obstructive shock is caused by physical obstruction of circulation either into or out of the heart. The mechanisms that lead to obstructive shock either prevent blood from entering the right heart during diastole such as a tension pneumothorax or pericardial tamponade, or prevent the heart from ejecting the blood due to a physical obstruction, as in the case of pulmonary embolism or left ventricular outflow obstruction. While supportive care with volume resuscitation and inotropes to maintain cardiac output is crucial, early determination of the cause with prompt treatment is needed to prevent circulatory collapse. This chapter reviews the pathophysiologic mechanisms leading to obstructive shock and management steps to stabilize the patient and treat the underlying cause.

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