Chart — Critical Care
Shock Types Comparison Chart
The four categories of shock share a final common result — failed oxygen delivery — but reach it by opposite routes, and they are managed in opposite directions. This chart lines up hypovolemic, cardiogenic, distributive, and obstructive shock by their hemodynamic fingerprints and first-line treatment so you can place a patient at the bedside.
Written by Apex Respiratory Editorial Team
Educational use only. This material supports respiratory therapy education and exam review. It is not medical advice and is not a substitute for clinical judgment, institutional protocols, or physician orders. Always follow facility policies and current provider orders, and verify calculations independently before clinical use.
The Four Shock Types Side by Side
| Type | Mechanism | Preload (CVP/PCWP) | Cardiac Output | SVR | SvO₂ | Typical Causes | First-line Treatment |
|---|---|---|---|---|---|---|---|
| Hypovolemic | Loss of intravascular volume | ↓ | ↓ | ↑ | ↓ | Hemorrhage, GI losses, burns, dehydration | Volume resuscitation; control ongoing losses |
| Cardiogenic | Pump failure | ↑ | ↓ | ↑ | ↓ | MI, arrhythmia, decompensated heart failure | Inotropes, treat the cause; avoid aggressive fluids |
| Distributive | Pathologic vasodilation | ↓ or normal | ↑ or normal | ↓ | ↑ early (impaired extraction) | Sepsis, anaphylaxis, neurogenic | Fluids plus vasopressors (norepinephrine first-line) |
| Obstructive | Mechanical obstruction to flow | ↑ (often) | ↓ | ↑ | ↓ | Tension pneumothorax, cardiac tamponade, massive PE | Relieve the obstruction (decompress, pericardiocentesis, thrombolysis) |
Clinical Notes
- Warm vs cold shock. Distributive shock is the warm, vasodilated, low-SVR state; hypovolemic, cardiogenic, and obstructive shock are cold and vasoconstricted with a high SVR — the skin exam and SVR separate them fast.
- A high SvO₂ can mislead. In early septic shock the mixed venous saturation is high because the tissues cannot extract oxygen, not because delivery is excellent — read it as impaired extraction.
- Mixed pictures are common. Shock states overlap — a septic patient can also be cardiogenic — so the profiles blur and a patient may need more than one line of treatment at once.
- Read values in context. Always interpret a single hemodynamic number within the full clinical picture; pair an ABG and lactate trend from the ABG interpreter with the hemodynamics before committing to a category.
Related Resources
Sources
- Vincent JL, De Backer D. Circulatory shock. N Engl J Med. 2013;369(18):1726-1734.
- Kacmarek RM, Stoller JK, Heuer AJ. Egan's Fundamentals of Respiratory Care. 12th ed. Elsevier; 2021.