UMEM Educational Pearls

Category: Critical Care

Title: Uncommon Causes of Shock

Posted: 1/24/2023 by Mike Winters, MD (Updated: 5/29/2023)
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An Uncommon Cause of Shock

  • Sepsis is the most common cause of distributive shock encountered in the emergency department and intensive care unit.
  • Notwithstanding, it is important to consider other etiologies of shock, especially when the patient is not responding to resuscitation.
  • Adrenal crisis is one uncommon etiology of distributive shock whereby the diagnosis is often delayed.
  • Risk factors for adrenal crisis can include recent GI illness, thyrotoxicosis, recent surgery, and physical or psychological stress.
  • Patients often have nonspecific symptoms of generalized weakness, abdominal pain, vomiting, fever, and altered mental status.
  • Current guidelines recommend the administration of 100 mg of hydrocortisone in adults suspected of having adrenal crisis.   

References

Narayan S, Petersen TL. Uncommon etiologies of shock. Crit Care Clin. 2022; 38:429-441.