Methodologic and therapeutic approach to patients in shock

: The authors extensively review pathophysiology and clinical aspects of the several forms of shock. Then they report a statistical evaluation of the incidence of the different shocks in the Campania area and an analysis of the therapeutic protocols used in several medical centers. From January 1983 to May 1986, 212 patients in shock have been followed: 90 patients with hypovolemic shock; 81 patients with cardiac shock; 24 patients with shock caused by abnormal peripheral distribution; 17 patients with obstructive shock; Furthermore, from January to May 1986, in a multicenter cooperative study (69 medical centers evenly distributed all over Italy) operational factors that could be considered prognostic factors have been investigated utilizing a questionnaire. Finally the authors extensively discuss the therapeutic management of shock proposing new therapeutic protocols based on recent knowledge concerning the pathophysiology of the several clinical features investigated.