Distributive shock is one of the most important shock states to recognize in emergency and critical care medicine. In this high-yield breakdown, we cover pathophysiology, clinical presentation, hemodynamics, and evidence-based management — including sepsis, anaphylaxis, and neurogenic shock.
You’ll learn: ↓ SVR and “relative hypovolemia” Warm shock vs late cold shock progression Hyperdynamic cardiac output in early sepsis Neurogenic shock and bradycardia When to use fluids vs vasopressors Norepinephrine as first-line pressor When to add vasopressin or steroids Key trials: EGDT, ProCESS, ARISE, ProMISe, VASST, SOAP II, ADRENAL, APROCCHSS.
Management pearls: Fluids + antibiotics early in septic shock IM epinephrine first-line for anaphylaxis Phenylephrine or norepinephrine in neurogenic shock MAP ≥ 65 mmHg, lactate clearance, urine output targets
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