[The current situation and trends in the clinical treatment of shock].
Shock is defined as hypoperfusion of tissues and/or organs. The initial focus of resuscitation following shock is on establishing an open airway and ensuring adequate ventilation and circulation. Causes of shock can be recognized quickly via clinical manifestations. A professional physical examination and observation of response to therapy can result in early diagnosis of the causes of unstable vital signs. Identification of shock symptoms in order to administer appropriate treatment quickly is key to saving patient lives, because "time is tissue". In all shock cases, treatments begin with an evaluation, resuscitation and immediate treatment of life-threatening symptoms. Patients may experience more than one kind of shock simultaneously, which further complicates their assessment and treatment. The critical care of shock should be done thoroughly and systematically in order to assess and manage patients so as to avoid dysfunctions in one organ damaging others. During emergency and critical management of shock patients, once a certain stage of assessment is completed, further evaluation is necessary to assess condition improvement. If improvement is confirmed, maintenance therapy may be considered. If improvement is not confirmed, it should be considered whether treatment is inadequate or misfocused, or whether the patient's response is atypically poor. In addition to timely resuscitation and ICU care, there are specific effective treatments for each type of shock. Such must be administered in accordance with guidelines, standard protocols and goal-oriented approaches. Trends in shock management currently focus on integrating guidelines, standard protocols and goal-oriented approaches into a "treatment bundle", which facilitates the implementation of clinical medical care and completes specific goals within a specified time limit to reduce the risk of multiple organ failure and death due to shock.
Huang
Go-Shine
GS
School of Medicine, National Defense Medical Center, ROC.
Hu
Mei-Hua
MH
Hung
Nan-Kai
NK
Tsai
Chien-Sung
CS
Liu
Tien-Chien
TC
Liaw
Wen-Jinn
WJ
D006801:Humans; D017410:Practice Guidelines as Topic; D012769:Shock / Q000175:diagnosis / Q000628:therapy*