In the late 1800s, while caring for a trauma victim, Warren characterized shock as "a momentary pause in the act of death." A great deal about shock has been discovered since this first description. Dorland's Medical Dictionary defines shock as a condition of profound hemodynamic and metabolic disturbance characterized by failure of the circulatory system to maintain adequate perfusion of vital organs. Shock is now being defined at the cellular level as the inadequate delivery of nutrients to the cells of the body. Because oxygen is the only nutrient that cells cannot store in any appreciable quantity, shock is also equivalent to inadequate oxygen delivery (DO2). Although there are many types of shock, this article concentrates on the pathophysiologic characteristics of hypovolemic shock.
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