When tissue hypoxia starts to create multi organ failure/dysfunction, each organ system suffers and often influences negatively the state of shock . Many vicious cycles are at play in decompensated shock stages. If treatment of the shock's cause is not successful or delayed, these vicious cycles fuel and exacerbate the downhill course. "Cytokine storm" is in full bloom! ...and as this animated diagram depicts... it is a catastrophic, and often terminal, condition to be in...!!!