Fox Steven, Vashisht Rishik, Siuba Matthew, Dugar Siddharth
Critical Care Medicine, Respiratory Institute, Cleveland Clinic.
Pulmonary Medicine, Respiratory Institute, Cleveland Clinic, Assistant Professor of Medicine, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University
Cleve Clin J Med. 2020 Jul 17. doi: 10.3949/ccjm.87a.ccc052.
Shock is common in critically ill patients with COVID-19, developing in up to 67% of patients in intensive care (5% to 10% overall) and is associated with high mortality. Optimal management requires prompt recognition with precise evaluation and differentiation. Correcting hypoperfusion and treating the underlying process are fundamental aspects of treatment. Undifferentiated shock may be treated initially with norepinephrine to optimize perfusion while additional evaluation is performed to categorize the shock pathophysiology. Physical examination, bedside echocardiography, hemodynamic monitoring, lactate and venous oxygen saturation are important components of the patient evaluation.
休克在新冠肺炎危重症患者中很常见，在重症监护患者中发生率高达67%（总体发生率为5%至10%），且与高死亡率相关。最佳管理需要迅速识别，并进行精确评估和鉴别。纠正低灌注和治疗潜在病因是治疗的基本方面。对于未分化的休克，最初可使用去甲肾上腺素治疗以优化灌注，同时进行进一步评估以明确休克的病理生理学类型。体格检查、床旁超声心动图、血流动力学监测、乳酸和静脉血氧饱和度是患者评估的重要组成部分。
