# Cryptic shock

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{{redirect|pre-shock|an earthquake that occurs before a larger one|foreshock}}
{{technical|date=July 2019}}
'''Pre-shock''' is also known as '''compensated shock''', or '''cryptic shock'''<ref name="Shoemaker 1996 pp. 300–18">{{cite journal | last=Shoemaker | first=WC | title=Temporal physiologic patterns of shock and circulatory dysfunction based on early descriptions by invasive and noninvasive monitoring. | journal=New Horizons (Baltimore, Md.) | volume=4 | issue=2 | year=1996 | issn=1063-7389 | pmid=8774804 | pages=300–18}}</ref><ref name="Chien 1967 pp. 214–288">{{cite journal | last=Chien | first=S | title=Role of the sympathetic nervous system in hemorrhage. | journal=Physiological Reviews | publisher=American Physiological Society | volume=47 | issue=2 | year=1967 | issn=0031-9333 | pmid=5342872 | doi=10.1152/physrev.1967.47.2.214 | pages=214–288}}</ref> describes the state in which the human body is still capable of offsetting the abnormally reduced [tissue perfusion](/source/tissue_perfusion) by exerting compensatory mechanism.<ref name="Shoemaker 1996 pp. 300–18"/>

For instance, in a solely [hypovolemia](/source/hypovolemia) without formally entering ''shock'' state, the body is able to constrict [peripheral vessel](/source/peripheral_vessel)s, accelerate [heart rate](/source/heart_rate), and boost [myocardial contractility](/source/myocardial_contractility) to compensate for the negative impacts out of a certain percentage reduction in total effective arterial blood volume. Thus, the person, particularly for those non-elderly who have higher [physical reserve](/source/physical_reserve), might not be symptomatic of such blood loss accounted for certain amount of total blood volume in the body and might even manifest a normal [systolic pressure](/source/systolic_pressure) as well as [diastolic pressure](/source/diastolic_pressure). Taken together, [tachycardia](/source/tachycardia), a modest change in ''overall'' [blood pressure](/source/blood_pressure) in either trend—increase or decrease—or [hyperlactatemia](/source/hyperlactatemia) that is not deemed to be ''moderate to severe'', are the likely only early signs of clinical shock.<ref name="Chien 1967 pp. 214–288"/>

Clinical shock aka uncompensated shock is termed ''overt'' shock.<ref name="Puskarich Trzeciak Shapiro Heffner 2011 pp. 1289–1293">{{cite journal | last=Puskarich | first=Michael A. | last2=Trzeciak | first2=Stephen | last3=Shapiro | first3=Nathan I. | last4=Heffner | first4=Alan C. | last5=Kline | first5=Jeffrey A. | last6=Jones | first6=Alan E. | title=Outcomes of patients undergoing early sepsis resuscitation for cryptic shock compared with overt shock | journal=Resuscitation | publisher=Elsevier BV | volume=82 | issue=10 | year=2011 | issn=0300-9572 | doi=10.1016/j.resuscitation.2011.06.015 | pmid=21752522 | pmc=3179778 | pages=1289–1293}}</ref>

==References==
{{reflist}}

{{shock types}}

Category:Intensive care medicine

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Adapted from the Wikipedia article [Cryptic shock](https://en.wikipedia.org/wiki/Cryptic_shock) by Wikipedia contributors ([contributor history](https://en.wikipedia.org/wiki/Cryptic_shock?action=history)). Available under [Creative Commons Attribution-ShareAlike 4.0 International](https://creativecommons.org/licenses/by-sa/4.0/). Changes may have been made.