Stages of Shock

Shock involves ineffective tissue perfusion and acute circulatory failure. The shock syndrome is a pathway involving a variety of pathologic processes that may be categorized as four stages: initial, compensatory, progressive, and refractory (Urden, Stacy, & Lough, 2014).

• Initial stage - cardiac output (CO) is decreased, and tissue perfusion is threatened.

• Compensatory - Almost immediately, the compensatory stage begins as the body’s homeostatic mechanisms attempt to maintain CO, blood pressure, and tissue perfusion.

• Progressive - The compensatory mechanisms begin failing to meet tissue metabolic needs, and the shock cycle is perpetuated.

• Refractory - Shock becomes unresponsive to therapy and is considered irreversible.

According to Urden, Stacy, & Lough (2014), as the individual organ systems die, MODS occurs. Death occurs from ineffective tissue perfusion because of the failure of the circulation to meet the oxygen needs of the cell.