vasodilatory shock

vasodilatory shock, vasogenic shock kinwa vasoplegic shock hii hrudayjanya shock, septic shock, allergine-prerit shock aanee hypovolemic shocks shockshey sambandhit vaidyakeey aapatkalin sthitee aahe. jevha raktavahinya achanak shithil hotat, tevha tyacha parinam vasodilationmadhye hoto. vasodilatory shockmadhye, raktavahinya khoop shithil hotat jyamule atee vasodilation hote aanee raktadab qamee hoto aanee rakt pravah khoop qamee hoto. puresa raktadab nasel tarr rakt aanee pranavayu sharirachya avayavanparyant pohochanyasathi dhakalale jaanar naheet. jarr vasodilatory shock kahee minitanpeksha jaast kaal tikala tarr oxygenchya kamataratemule sharirachya avayavanche nuksan houu lagate. itar prakarchya dhakkyanpramanech vasodilatory shockver twarit upchar kele pahijet, anyatha anek avyavanchya apkriya jhalyamule avayavanche kayamche nuksan kinwa mrutyu houu shakato.
upcharanmadhye samanyatah vasopressor, innotrops, drav kanika aanee punarujjivanacha parichay yancha vapar hoto. jarr vasodilatory shock vasopressorchya uchch matres pratisad denyat ayashasvi jhaala (≤ 0.5 mii. gra./qii. gra./minit norpinephrin-samatulya matra mhanoon paribhashit), mhanje too vasopressor-pratirodhak aahe aanee tyala apavartak vasodilatory shock kinwa fakt apavartak shock mhatale jaate. sahayak upcharanmadhye angiotensin II, hydrocartisone, thymine, catecholamines, escorbic acid aanee tyanchya sanyogancha samavesh hoto.
kaaran.
raktpravahatil jivanujanya sansarg, gambhir ellergychi pratikriya (anaphylaxis), pranaligat dahak pratisad lakshansamuchchay kinwa majjasanstheche nuksan (mendu aanee majjatantu) yamule vasodilatory shock houu shakato. yashivay, septic shock, neurogenic shock, anaphylactic shock, drugg aanee toxin-prerit shock, endocrine shock yasarkhya jawaljawal serve prakarchya distributive shockche jevha mool shock adhik gambhir hoto tevha refractory vasodilatory shockmadhye rupantar houu shakate.
sepsis heey vasodilatory shockche sarvat samanya kaaran aahe. sepsis vagalata, itar karananmadhye tivra swadupindacha daah, poost cardiopulmonary bipass vasoplegia aanee systemic inflammatory response syndromesathi itar triggers yancha samavesh hoto. raktatil qamee calcium moolye heey vasodilatory shockmadhye bhoomika bajavu shakatat.
pathophysiology.
hrudayavikarachya zatkyamule kinwa mothya pramanat raktastrav jhalyamule tivra raktastrav jhalelya dhakkyamule hrudayjanya dhakkyachya prakarananmadhye, qamee dhamani daab ulatavanyasathi shareer paridhiy vahinya sankuchit karate jyamule uutinche apure perfusion hote. vasodilatory shockmule, paridhiy raktavahinyanchya gulgulit snayunna sankuchit hone katheen hote. apavartak vasodilatory shockmadhye, paridhiy raktavahinyansambandhi gulgulit snayu vasopressor aushadhanchya upcharanna kharab pratisad detat.
vasopressinchi kamatarata vasodilatory shockmadhye mahattvachi bhoomika bajavu shakate. apavartak raktavahinyasambandhi aaghatamadhye, rugnala raktavahinyasambandhi sravachi kamatarata aanee raktavahinyasambandhi-prerit raktadabatil badalanna pragat pratikar donhi asatat. kahinni asey gruheet dharale aahe qee vasopressinchi kamatarata asalelya rugnanmadhye, barrow receptor uttejanamadhye ghat yasah, swayatt prativart qamee jhalele disatat. karnakendriya taana receptorsdware toone pratibandhit keela jaau shakato aanee nitrick auxide kinwa norpinephrine uchch parisancharan patalidvare vasopressinche prakashan pratibandhit kele jaau shakate.
vasodilatory shock haah sahasa sahanubhootishil majjasanstha, vasopressin arginine pranali aanee renin-angiotensin aldosteron pranali yasarkhya sharirik nuksan bharpai yantranechya karyakshamatemadhye guntalela asato.
nidan.
apavartak dhakka kinwa vasodilatory shockchi vyakhya badalate. 2018 madhye, american college auph chest physicianne sangitale qee ≤ 0.5 mii. gra./qii. gra./minit norpinephrin-samatulya matra mhanoon paribhashit kelelya uchch-matrechya vasopressor therapila apura pratisad midalyas teey disun yete.
vyavasthapan.
vasodilatory shockchi antarnihit karane ulat karane, hemodynamic sthir karane, hypoperfusion aanee hypoxiamule mootrapind, myocardial aanee itar avyavanna avyavanna dukhapatinpasun rokhane aanee shiranmadhil thromboembolisms guntaguntipasun sanrakshn karnyasathi aavashyak upayayojana karane heey upcharadarmyan sarvoch pradhanyakram mhanoon vaparale jaatat.
jyaa rugnanna apavartak dhakka basato, tyanchyat prabhavi raktadab purvavat karnyachya uddeshane prarambhik upchar samanyatah norpinephrine aanee dopaminechya parichayapasun suru hotat. vasopressin heey heey agent mhanoon yete.
tathapi, uchch-matra upcharpaddhaticha sambandh atee coronary, splanknick vasoconstruction aanee hypercogulationshy aahe. atee raktavahinyanmadhil sankochanamule hrudayatil utpadan qamee houu shakate kinwa visheshtah kamkuvat hrudayavikarache karya asalelyanmadhye hrudayatil jivgheni guntagunt dekhil houu shakate.
jyanchya raktavahinyasambandhi aaghat haah hypocalesemic cardiomyopathymule hoto, aanee hrudayatoon baher padanyacha ansh aanee aakunchan yaa donhi goshtinche dastaivajikaran karoon, jyanchyamadhye raktavahinyasambandhi aaghat hoto, calcium aanee sakriy jivansatva dii kinwa punarsanyojit manvi parathyroid samprerak upcharancha vapar vyavharya aahe, kaaran snayunchya aakunchanavar calciumchi sharirik bhoomika detana anek yashasvi prakarane nondavali gelee hotee.
yashasvi upcharansathi, bahu-shakheey chamoochya vishisht yogdanacha laabh ghene aavashyak aahe, keval gambhir kalji ghenare doctor aanee anekada sansargjanya rog tadnyach navhe tarr shwasan upchar, nursing, farmacy aanee itaranchya sahkaryane.
mahamarishastra.
nirikshanatmak abhyas asey suchavatat qee, gambhir aajari lokanpaiki sumare 6 teey 7 takke lokanna apavartak dhakka lagoo shakato.
purvasoochana.
jeev vachavanyasathi lavkar olakhane aanee jalad upchar suru karane heey mahattvache aahe. jarr vasodilatory shockver upchar naan kelyas, agadi alpakalin hypotensive masik palimule dekhil hriday v mutrapindanna dukhapat houu shakate. yamule gambhir aajari lokanmadhye mrutyudarhi vadhu shakato. apavartak shockmadhye eka mahinyachya aat serve-karananmule mrutyuche praman 50 takkyanpeksha jaast asate.

