Echocardiography in the Assessment of Shock

Abstract

The skills, training, and approach can differ from one place to another, but it is generally recommended to follow a unique systematic approach in the same setting due to the usual need for serial studies by different operators.The study can be focused or comprehensive. A systemic approach makes it easier to reveal the shock etiology and spot the hemodynamic parameter in need of correction (e.g., flow obstruction, volume responsiveness, inotropes, and vasoconstrictors). It is important to note that several mechanisms can interplay and hence the need for a comprehensive approach.Based on our experience, we describe below our stepwise approach (Fig. 1):Step 1: Confirm Shock State This is usually a clinical diagnosis combined with biomarkers (e.g., mottling, capillary refill time, low urine output, lactate, and central venous oxygen saturation). However, some novel POCUS