ABSTRACT
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.
- Copyright © 2020 The Cleveland Clinic Foundation. All Rights Reserved.
- Siddharth Dugar, MD⇑
- Pulmonary Medicine, Respiratory Institute, Cleveland Clinic, Assistant Professor of Medicine, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University
- Correspondence:
Siddharth Dugar, MD, Department of Pulmonary Medicine, Respiratory Institute, L22-0330, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195; dugars{at}ccf.org
ABSTRACT
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.
- Copyright © 2020 The Cleveland Clinic Foundation. All Rights Reserved.