Summary

• A clinical syndrome characterised by inadequate organ perfusion and tissue oxygenation due to an imbalance between oxygen delivery and tissue oxygen demand.
• Commonly diagnosed when signs of hypoperfusion are associated with low or declining BP.
• It may result from a number of disease processes, including pump failure (cardiogenic), loss of intravascular volume (hypovolaemic), failure of vasoregulation (distributive), or obstruction to blood flow (obstructive).
• Initial treatment aims to optimise oxygen delivery and reverse hypoperfusion through volume resuscitation, vasopressors for refractory hypotension due to vasodilation, management of cardiac dysfunction, and treatment of the underlying cause.
• Management of shock is best undertaken in a critical care environment.