Talk:Distributive shock

Bold rewrite

I did a bold rewrite of the article. It removed 2 sources one of which is a dead link, the other

Mitchell, Richard Sheppard; Kumar, Vinay; Abbas, Abul K.; Fausto, Nelson. "Chapter 4". Robbins Basic Pathology: With STUDENT CONSULT Online Access (8th ed.). Philadelphia: Saunders. ISBN 1-4160-2973-7.

I don't have access to. If Mitchell et al. has material that should be included if someone with access would do so, great. Comments and revisions welcomed. - - MrBill3 (talk) 02:41, 9 May 2014 (UTC)

Overall I like the article, well done. I do have some comments for possible improvement though. I'm worried that some parts have been oversimplified by relating more to a specific type of distributive shock (eg. sepsis) vs. the overall category of distributive shock. For example, the pathophysiology is described as being a lack of response to vasopressive agents. This is not the case for all forms of distributive shock. Consider hypoalbuminemia induced hypotension, this is a distributive shock that is not due to loss of responsiveness to vasopressive agents. A simpler, overarching definition may be better suited for this article. Also, under treatments it has been outlined into specific types of distributive shock. For this article it might be best to venture down the simpler pathway that overarches all of distributive shock, not just the individual types. Finally I would like to see mention of the hemodynamic differences between the shock types that define distributive shock, just my $.02. Like I said at the beginning though, article looks nice, good job! Heyinternetman (talk) 05:57, 9 May 2014 (UTC)

If you have some references that would be a big help. Most refs I have found veer pretty directly into septic shock. I wasn't aware of hypoabluminemia induced hypotension as a form of distributive shock. I thought the definition in the lede was pretty overarching, most articles I have found cite loss of vascular response to vasopressors (endo and exo) as a feature of distributive shock. As the treatments seem focused on the cause/type of shock I am not sure how to write up treatments without breaking them up as I did. As I said a pointer to some refs would help. Thank you for your input. - - MrBill3 (talk) 06:21, 9 May 2014 (UTC)

I couldn't find a source that describes hypoalbuminemia as a cause of distributive shock. Apparently liver failure can cause distributive shock. Certainly hypoalbuminemia is associated with critical illnesses that may include/lead to distributive shock. However I am not convinced that hypoalbuminemia per se causes distributive shock. Axl ¤ [Talk] 23:45, 9 May 2014 (UTC)

By the way, I have a copy of Robbins Basic Pathology. What exactly are you looking for? Axl ¤ [Talk] 23:57, 9 May 2014 (UTC)

Not looking for anything in particular from Robbins, just wanted to make sure I hadn't removed anything important. If there is an authoritative definition of distributive shock you could post it here and I could make sure the definition in the article aligns with it. Thanks. Hepatic insufficiency is listed under causes. - - MrBill3 (talk) 00:23, 10 May 2014 (UTC)

Hmm, actually there doesn't seem to be anything in Robbins about distributive shock. Axl ¤ [Talk] 16:32, 11 May 2014 (UTC)