Management of Shock

Definition and Classification of Shock

Shock is a life-threatening condition characterized by inadequate tissue perfusion and oxygenation, leading to organ dysfunction. It is classified into four main types: hypovolemic, cardiogenic, distributive (including septic, anaphylactic, and neurogenic shock), and obstructive shock.

Causes and Pathophysiology

Each type of shock has distinct underlying causes. Hypovolemic shock results from severe blood or fluid loss, cardiogenic shock stems from cardiac failure, distributive shock arises from systemic vasodilation, and obstructive shock occurs due to physical obstruction of circulation.

Clinical Presentation and Diagnosis

• Common signs include hypotension, tachycardia, altered mental status, cold and clammy skin (except in distributive shock where the skin may be warm).
• Diagnosis relies on clinical evaluation, hemodynamic monitoring, and laboratory tests such as blood lactate levels.

Treatment Strategies

Immediate intervention is critical. Treatment varies by type:

• Hypovolemic shock: Fluid resuscitation with crystalloids or blood products.
• Cardiogenic shock: Inotropes, vasopressors, and mechanical support.
• Distributive shock: Source control, antibiotics for sepsis, epinephrine for anaphylaxis.
• Obstructive shock: Relief of the underlying obstruction, such as pericardiocentesis or thrombolysis.

Prognosis and Prevention

Prompt recognition and management improve outcomes. Preventive measures include early sepsis treatment, risk factor modification, and patient education on anaphylaxis triggers.