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Monday's Leftovers: General Tso's Chicken

YumSugar — Mon, 14 Sep 2009 05:50:09 -0700

I haven't had Chinese for a while, and lately I've been craving the spicy-sweet flavor profile of that good old standby, General Tso's chicken.

Normally I order takeout at least once a week, but this month I'm on a tighter budget, so I'll take a different route and try to make a home-cooked rendition of this choice restaurant dish.

Not only am I saving money by using up the rest of yesterday's chicken, but I'm also going to lighten it up by eliminating the need for a deep-fryer - and I'll have dinner on the table in well under an hour. Make the recipe tonight.

Chinese Chicken Salad Two Ways - Beginner and Expert

partysugar — Fri, 25 Apr 2008 11:31:19 -0700

When the weather warms up, I crave fresh, flavorful dishes like Chinese chicken salad. It makes a great meal because it's filling, crunchy, and delicious.

Every home cook should master a couple of basic salad recipes, and since Chinese chicken is so popular, it's a great dish to add to your repertoire.

I've found two recipes - both are straight forward, simple, and scrumptious - for you to check out so read more.

Beginner Chinese Chicken Salad
From Better Homes and Garden magazine

Ingredients

1/4 cup water
3 tablespoons rice wine vinegar or white wine vinegar
1 cup sesame tahini
1 tablespoon reduced-sodium soy sauce
2 teaspoons sugar
2 teaspoons finely chopped beni shoga (pickled ginger), drained, or 1 teaspoon grated fresh ginger
1 clove garlic, minced
1/8 teaspoon pepper
4 cups shredded Chinese (napa) cabbage or lettuce
2 cups shredded cooked chicken or turkey
1 cup carrots cut into julienne strips
1 cup pea pods, halved lengthwise
1 cup seeded cucumber cut into julienne strips
1 cup red sweet pepper cut into julienne strips
1/2 cup sliced green onions
1 3-ounce package low-fat ramen noodles

Directions

For dressing, in blender container or food processor bowl combine water, vinegar, tahini, soy sauce, sugar, beni shoga or ginger, garlic, and pepper. Cover and blend or process until smooth. Set aside.
In a large salad bowl toss together cabbage or lettuce, chicken or turkey, carrots, pea pods, cucumber, sweet pepper, and onions.
Remove seasoning mix from ramen noodle package; save for another use.
With hands, break noodles over salad. Pour dressing over salad and toss gently to mix. Serve immediately.

Serves 4.

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Expert Chinese Chicken Salad
From Food and Wine magazine

Ingredients

1 whole, bone-in chicken breast with skin (1 1/4 pounds)
4 scallions, 1 thinly sliced
One 1-inch piece of peeled fresh ginger, thinly sliced, plus 1 1/2 teaspoons finely grated ginger
Salt
3 tablespoons vegetable oil, plus more for frying
8 wonton wrappers, cut into 1/3-inch strips
3 tablespoons unseasoned rice vinegar
1 tablespoon Asian sesame oil
2 teaspoons soy sauce
Freshly ground pepper
3/4 pound baby bok choy, stems halved, leaves left whole
2 cups mizuna (1 ounce)
1 cup mung bean sprouts (3 ounces)
1 medium carrot, julienned
1 tablespoon chopped cilantro
1/4 cup chopped roasted salted peanuts

Directions

In a medium saucepan, cover the chicken breast with water and bring to a simmer over moderately high heat. Reduce the heat to low and skim.
Add the 3 whole scallions, the sliced ginger and a pinch of salt. Simmer until the chicken breast is cooked through, about 25 minutes.
Transfer the chicken to a plate and let cool to room temperature. Discard the skin and bones and shred the meat.
In a medium saucepan, heat 1/2 inch of the vegetable oil over moderately high heat until shimmering. Add a small handful of the wonton strips and fry over moderate heat until crisp and golden brown, about 10 seconds. Drain on paper towels and repeat with the remaining wonton strips.
In small bowl, whisk the rice vinegar with the sesame oil, soy sauce, grated ginger and 3 tablespoons of vegetable oil. Season with salt and pepper.
In a large bowl, toss the sliced scallion, bok choy, mizuna, bean sprouts, carrot, cilantro and peanuts. Add the chicken, wonton strips and dressing; toss and serve.

Serves 4.

Make ahead: the poached chicken breast can be refrigerated overnight. The fried wonton strips can be stored overnight at room temperature.

One Serving 386 cal, 24 gm fat, 4.0 gm sat fat, 16 gm carb, 3 gm fiber.

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Monday's Leftovers: Steak and Bok Choy Stir-Fry

YumSugar — Mon, 25 Aug 2008 07:45:38 -0700

Stir-fried steak reminds me of a dish my mother used to make. This recipe calls for skirt steak, but flank steak or any leftover steak would taste great in this dish.

With rice, vegetables, and peanuts, this balanced, bold-flavored dish is a great way to have dinner on the table in less than an hour. To get the recipe, read more.

Skirt Steak and Bok Choy Stir-Fry
From Everyday Food magazine

Ingredients

2 tablespoons soy sauce
2 tablespoons rice vinegar
1 tablespoon peanut butter
1 tablespoon honey
2 garlic cloves, minced
Coarse salt and ground pepper
1 pound skirt steak, thinly sliced crosswise
1 tablespoon cornstarch
1 teaspoon vegetable oil
1 large head bok choy, cut 1-inch thick crosswise
4 medium carrots, halved lengthwise, thinly sliced on bias
Cooked rice, for serving
1/4 cup peanuts, chopped

Directions

In a small bowl, mix soy sauce, vinegar, peanut butter, honey, and garlic; season with pepper.
In a bowl, toss steak with cornstarch; season with salt and pepper.
In a large nonstick skillet with a lid, heat oil over medium-high. Add half of steak; cook, tossing, until browned, 1 to 2 minutes. Transfer to a plate; repeat with remaining steak.
To skillet, add soy mixture, bok choy, and carrots. Cover and cook, tossing occasionally until tender, about 5 minutes.
Return steak to skillet; cook until heated through, about 5 minutes.
Serve over rice; sprinkle with peanuts.

Serves 4 to 6.

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Must-Read: Dinner At My Place

YumSugar — Mon, 11 May 2009 03:30:49 -0700

Over the past few months, I've been testing recipes from Tyler Florence's recent cookbook: Dinner At My Place $13.57.

Although Florence has penned several other cookbooks, this one has a particularly intimate feeling because it includes his family's favorite recipes along with great menus for dinner parties.

To find out if you should add it to your cookbook collection,
read more.

Pros:

The book is divided into innovative menus and theme parties. Some examples are Crab Season, Tolan's Birthday Dinner, and Sunday Dinner. There are a wide variety of recipes in each menu, which can be easily mixed and matched.
Many of the recipes offer substitutions in case some of the ingredients are not in season or are unavailable.
The last chapter, Cheat Sheet, has over 20 basic recipes (such as creamy parmesan potato gratin, Japanese beef broth, classic French Vinaigrette) that are fast and easy staples perfect for livening up any meal.

Cons:

Tyler is the father of three children, however, I thought it was overkill to dedicate an entire chapter to baby food. Perhaps a separate book or a smaller section? After all, I'm not making puree of anything for my adult guests anytime soon.
Directions for the recipes are in paragraph format rather than number.

Recipes: There are a wide variety of recipes in each of his pre-planned menus. Here are some that caught my attention.

Garden Puree Bruschetta
Blender Béarnaise
Watermelon Nectar with Lime Salt
Spicy Black-Eyed Pea Relish
Corn Pudding with Poblano
Artichoke Fritters with Meyer Lemon Salt
Beet Cakes with Sweet Greek Yogurt
Chinese Chicken Stock
Bourbon Peach Cobbler

Imagery: There are tons of pictures, which I promise will get you salivating.

Overall Rating: This cookbook has plenty of recipes perfect for a dinner party. It's not filled with lengthy and difficult culinary challenges, but rather tasty comfort foods that an average family is sure to enjoy.

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Talking Food With Cookbook Authority Sheila Lukins

YumSugar — Thu, 05 Feb 2009 16:15:00 -0800

Sheila Lukins is one of America's most prolific cookbook authors. More than 25 years ago, she published The Silver Palate Cookbook, which introduced the boomer generation to upscale at-home cuisine. In addition to publishing other blockbuster cookbooks, Lukins has edited the food pages of Parade magazine for over 20 years.

I had a chance to enjoy breakfast with Sheila on a sunny Saturday morning, while she was on tour for Ten, her latest (and seventh!) cookbook. Over coffee, she offered her best tips for home cooks, and talked about the ever-so-controversial seasonality issue. To see more of what she had to say, read more.

YumSugar: Why did you come out with Ten?
Sheila Lukins: My editor [Peter Workman], and I were talking about all the foods we craved. Everybody really has the same favorite foods; we all love noodles, ribs, Italian food. He said, there's a book in that - you could have 10 recipes for each of your favorite foods.

YS: You've got whole chapters dedicated to tomatoes, corn, asparagus. Should home cooks use seasonal vegetables year-round?
SL: I believe in eating seasonally; there's nothing like going to the farmers market and getting Silver Queen corn, but you get certain things year-round these days. It's not like I want to eat hard or yellow strawberries, but . . . certain tomatoes, let them ripen on the counter, and they're okay. I'm not going to say I'm never going to eat [an out-of-season] tomato.

YS: Why do you think your books resonate with people?
SL: The recipes are so clearly written; they are so specific. I make up every recipe, first with a yellow pad at the stove, at home, in my own kitchen - and they work. We go over it and over it and over it. You can't do bad recipes, and then have people spend money on ingredients and get a recipe that doesn't work well. That's so horrible.

YS: What were some of your most memorable moments in the kitchen?
SL: I got almost electrocuted by an eggplant. I wrapped it in aluminum foil and was baking it so I could make baba ghanoush. I opened the foil and got a horrible shock!

YS: What's your advice for the home cook?
SL: Find a couple things you enjoy making. Try them ahead of time, then make them when you're having people over. Don't feel like you have to make every dish in a cookbook. Most people don't; they have their favorites. Read recipes through, and be sure you have your ingredients. Make sure you check your cabinets, and keep things in stock so you don't have to keep shopping from scratch every time you want to cook.

YS: Where are your favorite places to eat out?
SL: In New York, I used to go downtown a lot, but now I go a lot less because there are such good places on the Upper West Side. I love Tom Valenti and his restaurants - that would be Ouest, and a new one, West Branch. Craft is very good for special occasions. Love Balthazar. I always get Chinese food from Shun Lee West, and I get pizza from Patsy's because they deliver, and it's near my house. Because I've lived on the Upper West Side, these are places that are very convenient to me, and also very delicious. We used to have no good food on the Upper West Side. Daniel Boulud just opened Bar Boulud, and I go there a lot.

Photo Courtesy of Francesco Scavullo

Come Party With Me: Chinese New Year - Menu

partysugar — Tue, 20 Jan 2009 11:45:36 -0800

The lunar New Year and the year of the ox begins on Jan. 26. To celebrate, gather friends and family for a Chinese-style banquet. Food symbolism plays an important role in Chinese New Year, so select the menu carefully. Start by serving mushroom spring rolls. The crispy, golden rolls represent gold bouillon. Serving a chicken whole represents a sense of unity - this recipe produces juicy, tender meat. Chinese noodles seasoned with soy sauce, sesame oil, and cilantro signify longevity. Oysters braised with sea moss is a traditional dish that brings luck to business transactions and rounds out the menu. To look at these recipes, read more.

Mushroom Spring Rolls with Creamy Ginger Sauce
From Food and Wine

Ingredients

3 tablespoons unsalted butter
1/2 pound oyster mushrooms, cut into 1/2-inch pieces
1/2 pound shiitake mushrooms, stems discarded, caps sliced 1/4 inch thick
1/2 pound cremini mushrooms, sliced 1/4 inch thick
2 tablespoons Shaoxing wine or dry sherry
2 tablespoons soy sauce
Salt and freshly ground pepper
2 tablespoons extra-virgin olive oil
2 garlic cloves, thinly sliced
1 plump lemongrass stalk, tender white inner bulb only, minced
1 red Thai chile, minced
1 medium shallot, minced
1 tablespoon plus 1 1/2 teaspoons minced fresh ginger
1/2 teaspoon finely grated lemon zest
10 thin egg roll or spring roll wrappers
1 large egg, beaten
1/4 cup mayonnaise
1/4 cup vegetable oil, plus more for frying
1 tablespoon chopped tarragon
1 tablespoon fresh lime juice
1 tablespoon rice vinegar
10 Boston lettuce leaves, halved

Directions

In a very large skillet, melt the butter. Add all of the mushrooms, the wine and soy sauce and season with salt and pepper. Cook over high heat, stirring, for 1 minute. Cover and cook over moderately low heat, stirring a few times, until the mushrooms have released their liquid and are tender, about 8 minutes.
Uncover and cook over moderate heat, stirring occasionally, until browned, about 4 minutes longer.
In a small skillet, heat the olive oil. Add the garlic, lemongrass, chile, shallot and 1 tablespoon of the ginger and cook over low heat, stirring occasionally, until the vegetables are golden brown, about 7 minutes. Add the lemon zest, then stir the mixture into the mushrooms.
On a work surface, lightly brush an egg roll wrapper with the beaten egg. Spread 1/4 cup of the mushrooms on the lower third of the wrapper; bring the lower edge up and over the filling and roll up, folding in the sides as you go. Lightly flatten the roll and brush it with the beaten egg. Repeat with the remaining wrappers and filling.
In a blender, puree the mayonnaise with the 1/4 cup of vegetable oil, the tarragon, lime juice, vinegar and the remaining 1 1/2 teaspoons of ginger until smooth. Season with salt and pepper.
Line a baking sheet with paper towels. In a medium skillet, heat 1 inch of vegetable oil to 250°. Add 3 or 4 spring rolls and fry gently until nicely browned, about 1 minute per side. Drain on the prepared baking sheet and repeat the frying with the remaining spring rolls.
Cut the rolls in half on the diagonal, wrap them in lettuce leaves and serve right away with the ginger sauce.

Makes 10 spring rolls.

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White-Cut Chicken
From Gourmet

Ingredients

For chicken
1 (3- to 3 1/2-lb) whole chicken (with head and feet if desired), neck (if without head) and giblets reserved for another use if desired
1 bunch scallions, halved crosswise
2 oz Smithfield or other cured ham (1 piece or sliced), trimmed of any spice coating
6 (1/4-inch-thick) round slices peeled fresh ginger
14 cups water
1 teaspoon salt
1 teaspoon Asian sesame oil
1/2 cup fresh cilantro leaves
For dipping sauce
1 bunch scallions (white and pale green parts only), cut into very thin 2-inch strips
3 tablespoons light soy sauce (preferably Pearl River Bridge brand)
3 tablespoons peanut or vegetable oil
1 tablespoon finely grated (with a rasp) peeled fresh ginger

Directions

Make chicken: rinse chicken inside and out, then bend legs to tuck feet (if still attached) inside cavity. Stuff cavity with scallions, ham, and ginger.
Bring water with salt to a boil in a deep 7- to 8-quart stockpot or pasta pot. Add chicken, breast side down (chicken may not be completely covered with liquid), then reduce heat and simmer, covered, 20 minutes.
Remove from heat and let stand, covered, 30 minutes. Turn chicken over and let stand, covered, 15 minutes more (chicken will be cooked through).
While chicken stands, fill a large bowl three-fourths full with ice and cold water. Carefully remove chicken from pot with a large slotted spoon and plunge into ice water to stop cooking. Let stand, gently turning over once (be careful not to tear skin), until cool, about 10 minutes total. Carefully transfer to a cutting board and discard scallions, ham, and ginger from cavity. Pat dry. Rub skin with sesame oil.
Make dipping sauce: stir together scallions and soy sauce in a small heatproof bowl.
Heat wok over high heat until a drop of water vaporizes instantly. Pour oil around side of wok, then tilt wok to swirl oil, coating sides. When oil just begins to smoke, carefully add ginger (oil will spatter) and stir-fry 30 seconds. Immediately remove from heat and pour over scallion mixture, stirring to combine (scallions will wilt).
To cut and serve chicken on a platter (Chinese restaurant–style), cut off the head and neck (if attached) with a cleaver and put at one end of a large platter. (These parts, along with the back and feet, aren't always eaten.) Cut off the feet. Cut off the drumsticks and thighs, then cut crosswise through the boneinto 1-inch pieces. Place the feet and leg meat at the other end of the platter. Cut off the wings, separating them at the joints, and put on the sides of the platter. Cut through the ribs, separating breast from back, then cut the backbone crosswise into 3 pieces and put them in the center of the platter. (Striking the cleaver with a rubber mallet makes the cuts clean.) Cut the breast crosswise through the bone into 1-inch pieces and arrange on the back. Alternatively, cut chicken according to procedure and mound pieces in a bowl.
Drizzle 2 tablespoons dipping sauce over chicken and sprinkle with cilantro leaves. Serve warm or at room temperature, with remaining dipping sauce on the side.

Serves 8.

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Chinese Noodles with Sesame Dressing
From Everyday Food

Ingredients

1 package (8 ounces) thin Chinese noodles
1/4 cup fresh lime juice
2 tablespoons soy sauce
1 teaspoon toasted sesame oil
2 teaspoons light-brown sugar
1/8 to 1/4 teaspoon crushed red pepper
3 tablespoons chopped fresh cilantro
Coarse salt and freshly ground pepper

Directions

In a large pot of boiling water, cook noodles according to package instructions. Drain; rinse under cold water until completely cool. Set aside.
In a large bowl, combine lime juice, soy sauce, sesame oil, sugar, red pepper, and cilantro. Add noodles; toss to combine. Season with salt and ground pepper, and serve.

Serves 6.

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Braised Oysters with Sea Moss
From Food Network

Ingredients

11 ounces Chinese and iceberg lettuce leaves
8 jumbo oysters
2 tbsp vegetable oil
8 black mushrooms, soaked in water
0.7 ounces sea moss, soaked in water
1/3 cup +2 tbsp chicken stock
2 tbsp oyster sauce
1 tsp sesame oil
Salt, to taste
1 tsp sugar
1 tsp cornstarch
1 tbsp water

Directions

Blanch lettuce quickly in seasoned water, remove and line a serving dish with the leaves.
Poach oysters in the same water until 50% cooked. Remove.
Heat Chinese wok and quickly sauté oysters with vegetable oil. Add the black mushrooms, sea moss, chicken stock and oyster sauce. Cook for a few minutes until the mushrooms are soft.
Season the sauce with sesame oil, salt and sugar. Mix cornstarch with water. Add enough of the cornstarch mixture to slightly thicken the sauce.
Place oysters, black mushrooms and sea moss on top of lettuce.

Serves 4.

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Celebrate the Oscars With an Animated Movie Night

LilSugar — Fri, 20 Feb 2009 14:16:48 -0800

The Academy Awards air this Sunday past your lil one's bedtime, but that doesn't mean your family has to miss out on the fun! The Best Animated Feature Film nominees, Wall-E, Kung-Fu Panda and Bolt have all been released on DVD, so why not curl up on the couch with your family for a screening or two (or three!)? You may not have the time to replicate all of PartySugar's amazing Oscar Party suggestions and recipes, but consider infusing your celebratory cinema time with extra special effort.

Turn Decorating Into an Art Project: Print out small pictures from the three movies (just do a Google image search and pick your favorites), and set up an art station with your printouts, construction paper, ribbons, glitter, and crayons. After your children decorate the pictures, turn them into a festive banner.
Make Traditional Movie Snacks: PartySugar is serving up popcorn with truffle oil, Parmesan cheese, and black pepper. If your tots have finicky taste buds, make a few bowls of popcorn and sprinkle in a handful of chocolate covered raisins. More truffle oil for the adults!
Theme Your Main Course: If you are watching Kung-Fu Panda order Chinese takeout or make stir-fry, if you are watching Bolt, which takes place in the US, cook up some burgers or comfort food, and if Wall-E is your game, make futuristic food using food coloring and creative shapes (time to whip out those cookie cutters!).
Make a Kiddie Ballot: You can cast your vote for the winners on BuzzSugar for a chance to win a year of movies, but online voting may be a bit advanced for your tots. Print out a simple homemade ballot for your children and let them pick their favorite of the three films before the award show.

Source

Top 5 Flavor Pairing Predictions for 2009

YumSugar — Mon, 05 Jan 2009 11:16:02 -0800

At the onset of each year, American spice company McCormick offers its prediction for the top spice combinations. When we shared the company's top picks with you last year, your vote went to the vanilla and cardamom combo. Incidentally, throughout 2008, I encountered that flavor pairing in recipes and menu items from flan to peach pie. McCormick recently released its forecast for 2009. To see five of the new flavor combinations predicted to explode onto the food scene (and your tongue) this year, read more.

Toasted sesame and root beer
Chinese five spice and artisan-cured pork
Dill and avocado oil
Mint and quinoa
Smoked paprika and agave nectar

The Peruvian grain quinoa has been gaining popularity, and I've already seen recipes for it tossed with mint and other herbs. With the shift away from high-fructose corn syrup and toward natural sweeteners, I could see agave nectar and smoked paprika being a big hit. Toasted sesame and root beer? That's an interesting idea, but I'd have to try it in order to believe it will take off.

What are your thoughts on the flavor forecast?

Source

'Wich of the Week: Tofu and Chinese Broccoli

YumSugar — Wed, 06 Aug 2008 14:00:20 -0700

With all this talk about Chinese barbecue and dim-sum Olympics parties, I've had Chinese food on the brain. So on my last trip to the farmers market, I picked up some Chinese broccoli, a yummy in-season green that tastes like a cross between asparagus, broccoli, and bok choy. After making a tofu stir-fry, I refocused the remaining ingredients into an elegant vegetarian sandwich. I used wheat bread, because that's what I had on hand, but any sliced bread will do. I also had some garlicky homemade almond butter leftover from another recipe, but if you don't want to make your own, I recommend mixing crushed garlic into regular peanut butter or almond butter for an Asian-inspired spread. To get both recipes and see how I made this tofu treat, read more.

Tofu and Chinese Broccoli Sandwich
Original recipe

Ingredients

4 stalks Chinese broccoli, washed and ends trimmed (if you can't find Chinese broccoli, asparagus or bok choy are good substitutes)
1 teaspoon vegetable oil
1 tablespoon soy sauce
1/8 cup sake or rice-wine vinegar
2 slices wheat bread
1 tablespoon almond butter (or more to taste)
2 oz. baked tofu (such as Soy Deli Five Spice), cut into 1/4-inch slices

Directions

Preheat oven to 300°F.
In a skillet over low heat, combine vegetable oil, soy sauce, and Chinese broccoli; toss to coat.

Cook broccoli for about 5 minutes, turning frequently, until leaves start to wilt and stalks begin to brown.
To the skillet, add sake or rice-wine vinegar and cook for an additional 5 minutes, using the liquid to deglaze the pan. When the broccoli is tender, remove from heat.
Lay both slices of bread on an baking sheet or other oven safe platter. On one slice of bread, spread half the almond butter and top with the tofu slices. Using a spatula, lay the broccoli atop of the tofu, and drizzle any remaining liquid from the pan on top.

Place both slices of bread and the toppings in the oven for about 5 minutes, until bread is toasted.
Spread remaining almond butter on other slice of bread, and press it, spread-side down, onto the broccoli. Cut in half and serve.

Makes one sandwich.

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Almond Butter
Modified From Epicurious

Ingredients

1/2 cup toasted Marcona almonds
1/2 garlic clove, chopped
Pinch of cayenne
1/2 to 1 tablespoon extra-virgin olive oil

Directions
Grind almonds to a paste with garlic, 1/4 teaspoon salt, and cayenne in a food processor. With motor running, add just enough oil to make a silky paste. Season with salt.

Makes about 1 cup.

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Shock

FitSugar — Wed, 08 Oct 2008 17:35:07 -0700

HEALTH GUIDE REFERENCE FROM A.D.A.M

Shock occurs when your blood pressure falls to a very low level. As your blood pressure falls, your brain and other organs don't get enough blood or oxygen to function, and they begin to fail. Shock can arise from any of a number of causes. It is a life-threatening medical emergency and must be treated early to avoid serious complications and even death.

Signs and Symptoms

Common signs and symptoms of shock include the following:

Low blood pressure
Altered mental state, including reduced alertness and awareness, confusion, and sleepiness
Cold, moist skin. Hands and feet may be blue or pale
Weak or rapid pulse
Rapid breathing and hyperventilation
Decreased urine output
In septic shock (from overwhelming blood infection) -- shaking chills, rapid temperature increase, warm, flushed skin, and rapid pulse
In shock related to heart problems -- lung congestion, rapid pulse, heart murmur, enlarged neck veins

What Causes It?

Shock can have several causes. Doctors classify shock according to four categories:

Loss of fluid in the bloodstream (hypovolemic shock) -- occurs after heavy bleeding from an injury or a condition such as bleeding ulcers. Hypovolemic shock can also occur if your body loses too much fluids other than blood (such as losing water after severe diarrhea or vomiting, or losing plasma after serious burns).

Blood vessels become too dilated (distributive shock) -- If the blood vessels expand too much, they are not able to keep blood circulating to all organs. Septic shock, which occurs when bacteria invade the bloodstream, and anaphylactic shock, which is a severe allergic reaction, are examples.

Heart problems (cardiogenic shock) -- In this case, the heart doesn't pump enough blood through the body. It can be caused by a heart attack, abnormal heart rhythm, or damage to the heart from heart disease.

Who's Most At Risk?

The following conditions and characteristics increase the risk for shock:

Serious injury and trauma
Heart conditions such as heart disease or heart attack
Surgery
Bacterial infection that has spread to the blood
Bleeding
Losing large volume of fluids from severe diarrhea or vomiting
Excessive alcohol use
Severe anemia
Weakened immune system
Allergic reaction to a drug, food, or environmental exposure
Drug overdose
Pregnancy

What to Expect at Your Provider's Office

Shock is an emergency and requires immediate conventional treatment. Your health care provider will diagnose shock based on your symptoms and any information about underlying disease or recent injury. Your health care provider will check blood pressure, assess mental status (memory, orientation, and alertness), measure urine output, and order blood tests to check heart, lung, and kidney function and search for evidence of sepsis (blood infection). Imaging and other procedures -- such as x-ray, electrocardiography (ECG), echocardiography -- may be performed to check the heart.

Treatment Options

Prevention

If you have heart disease or another condition that makes you susceptible to shock, you should make sure you are treated for that condition. If you have severe allergies, avoid substances that may trigger anaphylactic shock and carry self-injectable epinephrine to treat anaphylaxis.

Treatment Plan

The main goals of treatment are to maintain blood pressure and to make sure the person's vital organs get enough blood and oxygen. First aid for shock includes having the person lie on their back, raising their legs to help blood return to the heart, stopping any bleeding, covering them with a coat or blanket to ensure warmth, and performing cardiopulmonary resuscitation (CPR), if needed. Emergency medical staff will administer oxygen and, in the case of hypovolemic and septic shock, intravenous fluids.

Drug Therapies

The following medications may be used to treat shock:

Drugs that increase pressure in the arteries and help the heart pump more blood, such as dopamine, dobutamine, and norepinephrine
Medications to either dilate or constrict blood vessels (depending on the cause of shock)
Antibiotics for septic shock, to combat wide-ranging infection
Thrombolytic therapy (drugs that dissolve clots as they form) may be considered in the case of heart attack or pulmonary embolism

Complementary and Alternative Therapies

Shock is always life-threatening and requires emergency conventional medical care. Some complementary and alternative therapies, however, may be used along with conventional treatment, after a person's condition stabilizes to help prevent shock. For instance, certain nutrients may help protect against the harmful effects of shock and improve the outcome of conventional treatment.

Nutrition and Supplements

Oxidative stress (damage to cells caused by the body's normal use of oxygen) may play a role in shock. Several studies have suggested treatment with antioxidants that help rid the body of free radicals (harmful byproducts of the oxidative process) may protect against some types of shock. However, most of these have been animal studies. It is not known whether or not these supplements will also benefit humans.

L-carnitine, a substance which occurs naturally in the body's cells, may be helpful in treating cardiogenic, septic, and hypovolemic shock. A study of 115 patients with septic, cardiac, or traumatic shock showed that acetyl-L-carnitine helped return heart rate and blood pressure to normal and boosted oxygen delivery throughout the body.
Coenzyme Q10, an antioxidant, may be beneficial in treating hypovolemic and septic shock. One study of hemorrhagic (bleeding-related) shock in animals showed that coenzyme Q10 helped protect lung function and improve blood flow. A study on animals with septic shock showed that coenzyme Q10 improved heart function, blood flow, and blood pressure. Another suggested that pretreatment with coenzyme Q10 improved lung function of the animals who later developed septic shock.
Glutamine added to parenteral nutrition (nutrients given through the veins, or IV) may protect the intestines and prevent complications from septic shock.
Omega-3 fatty acids -- Animal studies show that omega-3 essential fatty acids, found in fish oil, may fight inflammation and may protect against septic shock.
Vitamins B₃ -- Animal studies have suggested that nicotinamide (a form of vitamin B₃) may help protect against bacteria that cause septic shock.
Vitamin B₁₂ -- Animal studies suggest that taking hydroxocobalamin (a form of vitamin B₁₂₎ may improve blood pressure.

Herbs

As noted, shock always requires emergency conventional medical treatment and should never be treated with herbs alone. Some herbs that support the immune system may be beneficial in treating septic shock, along with conventional medications. Talk to your doctor before taking any herbs to treat or prevent shock.

An Ayurvedic formula containing the following herbs helped reduce bacteria levels in the blood of rats infected with Escherichia coli (an infection that can spread to the bloodstream, potentially causing septic shock):

Ashwagandha (Withania somnifera)
Indian gooseberry (Phyllanthus emblica)
Sweet basil (Ocimum sanctum)
Tamarisk ( Tinospora cordifolia)

Several newly developed herbal remedies based on traditional Chinese medicine were evaluated for use in 183 people with septic shock. Injections of the following herbs appeared to increase blood circulation as well as lower the death rate significantly in the treatment group:

Kangjue tongmai
Yiqi huiyang
Yiqi jiuyin

Two herbs that have been used traditionally to treat shock are aconite (Aconitum napellus), a highly toxic herb that should only be used with a doctor's supervision, and ginseng (Panax ginseng).

Homeopathy

Scientific studies of homeopathic remedies for the treatment of shock specifically have not been conducted. The remedy Aconite, however, is often used by homeopathic doctors for emergency conditions. In homeopathic remedies, aconite is highly diluted, and only a trace amount of the herb is present, so it is not toxic in a homeopathic formulation.

Prognosis/Possible Complications

If someone suffering from shock receives immediate treatment, the prognosis is good. Immediate treatment for anaphylactic shock, for example, usually results in complete recovery. But any case of shock is life-threatening, regardless of its cause, particularly in the elderly. Shock often causes organ damage (including the kidneys, brain, and liver), cardiac arrest, and respiratory failure.

Following Up

If you are suffering from shock, you will likely be admitted to intensive care. Following treatment, your health care provider will carefully monitor your condition, including temperature, blood pressure, cardiac function, urine flow, and blood chemistry.

Supporting Research

Beers MH, Porter RS, et al. The Merck Manual of Diagnosis and Therapy. 18th ed. Whitehouse Station, NJ: Merck Research Laboratories; 2006:559-564.

Corbucci GG, Loche F. L-carnitine in cardiogenic shock therapy: pharmacodynamic aspects and clinical data. Int J Clin Pharmacol Res. 1993;13(2):87-91.

De la Fuente M, Victor VM. Anti-oxidants as modulators of immune function. Immunol Cell Biol. 2000;78(1):49-54.

Farolan LR, Goto M, Myers TF, Anderson CL, Zeller WP. Perinatal nutrition enriched with omega-3 polyunsaturated fatty acids attenuates endotoxic shock in newborn rats. Shock. 1996;6(4):263-266.

Felbinger TW, Suchner U, Goetz AE. Treating patients with severe sepsis [letter]. N Engl J Med. 1999;341(1):56-57.

Gasparetto A, Corbucci GG, De Blasi RA, et al. Influence of acetyl-L-carnitine infusion on haemodynamic parameters and survival of circulatory-shock patients. Int J Clin Pharmacol Res. 1991;11(2):83-92.

Greenberg SS, Xie J, Zatarain JM, Kapusta DR, Miller MJ. Hydroxocobalamin (vitamin B_12a) prevents and reverses endotoxin-induced hypotension and mortality in rodents: role of nitric oxide. J Pharmacol Exp Ther. 1995;273(1):257-65.

Hochman JS, Sleeper LA, Webb JG, et al. Early revascularization in acute myocardial infarction complicated by cardiogenic shock. N Engl J Med. 1999;341(9):625-34.

Jack RA. Aconite -- the number one shock and fever medicine. Hahnemannian. 1986;121(3):5-6.

Jin MW, Zhou ZY, Zhang SW. Study on treatment of infectious shock with recipe of liqi huoxue and kaibi gutuo [in Chinese]. Chung Kuo Chung Hsi I Chieh Ho Tsa Chih. 1995;15(10):589-592.

LeClaire RD, Kell W, Bavari S, Smith TJ, Hunt RE. Protective effects of niacinamide in staphylococcal enterotoxin-B-induced toxicity. Toxicology. 1996;107(1):69-81.

Lelli JL, Drongowski RA, Gastman B, Remick DG, Coran AG. Effects of Coenzyme Q10 on the mediator cascade of sepsis. Circ Shock. 1993;39(3):178-187.

Liu YY. Comparison between the therapeutic effects of ginseng-aconitum-bupleurum injection and dexamethasone on septic shock complicated with disseminated intravascular coagulation induced by E. coli in dogs. Zhong Xi Yi Jie He Za Zhi. 1990 Nov;10(11):675-6, 645.

Mendez C, Jurkovich GJ, Wener MH, Garcia I, Mays M, Maier RV. Effects of supplemental dietary arginine, canola oil, and trace elements on cellular immune function in critically injured patients. Shock. 1996;6(1):7-12.

Mitra SK, Gupta M, Suryanarayana T, Sarma DN. Immunoprotective effect of IM-133. Int J Immunopharmacol. 1999;21(2):115-120.

Victor VV, Guayerbas N, Puerto M, Medina S, De la Fuente M. Ascorbic acid modulates in vitro the function of macrophages from mice with endotoxic shock. Immunopharmacology. 2000;46(1):89-101.

Weimann A, Bastian L, Bischoff WE, et al. Influence of arginine, omega-3 fatty acids and nucleotide-supplemented enteral support on systemic inflammatory response syndrome and multiple organ failure in patients after severe trauma. Nutrition. 1998;14(2):165-172.

Winter BK, Fiskum G, Gallo LL. Effects of L-carnitine on serum triglyceride and cytokine levels in rat models of cachexia and septic shock. Br J Cancer. 1995;72(5):1173-1179.

Yamada M. Effects of coenzyme Q10 in hemorrhagic shock. Crit Care Med. 1990;18(5):509-514.

Zingarelli B, Salzman AL, Szabo C. Protective effects of nicotinamide against nitric oxide-mediated delayed vascular failure in endotoxic shock: potential involvement of polyADP ribosyl synthetase. Shock. 1996;5(4):258-264.

Review Date:
1/7/2007
Reviewed By:
Steven D. Ehrlich, N.M.D., private practice specializing in complementary and alternative medicine, Phoenix, AZ. Review provided by VeriMed Healthcare Network.

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