SHOCK

Shock is a syndrome that results in a critical imbalance between tissu e oxygen delivery and utilization. It is the final common pathway for most critical clinical diseases. Any functional disturbance or conditi on that results in a serious decrease in effective blood Row can be re sponsible for shock. The pathophysiologic and compensatory mechanisms that contribute to the clinical signs observed in shock patients conti nue to offer new insights that are essential to the development of imp roved therapeutic approaches. For example, the roles of nitric oxide a nd oxygen free radicals in Shock patients have provided a variety of t herapeutic opportunities that are currently being investigated, The ke y : components in initiating successful therapy for shock patients con tinue to be appropriate fluid therapy (involving crystalloids, colloid s, blood substitutes, and blood), support of cardiac contractile funct ion (inotropes), and oxygenation of arterial blood. Successful managem ent of patients is based on adequate nursing care, supportive therapy, and treatment of obvious causative or functional disturbances. As und erstanding of the pathophysiology of shock increases, more specific th erapeutic regimens will be developed.