SHOCK MANAGEMENT: DIAGNOSTIC AND TREATMENT STRATEGIES

Abstract

Shock is a potentially fatal clinical syndrome characterized by tissue hypoperfusion and the inability of the circulatory system to supply sufficient oxygen to meet cellular metabolic demands. It is one of the main medical emergencies in emergency departments, intensive care units, and trauma settings, presenting high morbidity and mortality when not recognized and treated early. Its pathophysiology involves complex hemodynamic alterations that culminate in cellular dysfunction, anaerobic metabolism, lactate production, and progressive organ failure. The diagnosis of shock requires a rapid and systematic approach, based on clinical evaluation, hemodynamic monitoring, and identification of the underlying etiology. Among the main types are hypovolemic, cardiogenic, distributive, and obstructive shock, each with specific pathophysiological mechanisms and therapeutic strategies. Early recognition of the cause of shock is fundamental to directing appropriate interventions and reducing unfavorable outcomes. Therapeutic management includes airway stabilization, ventilatory support, volume replacement, rational use of vasoactive drugs, and definitive treatment of the triggering etiology. Furthermore, modern monitoring methods, bedside ultrasound, and goal-directed resuscitation protocols have been expanding diagnostic and therapeutic capabilities in critical situations. This article reviews the main pathophysiological mechanisms of shock, as well as current diagnostic, monitoring, and treatment strategies, emphasizing the importance of an early and individualized approach to reduce mortality.