Shock: the Revelation from Critical Hemodynamic Therapy

Shock, which has been recognized and treated in clinic for a long time, however, is a commonly seen lethal morbid state. The development of hemodynamics in critical care provides specific guidance and novel inspirations. Hemodynamics is a discipline defining the movement of blood flow and blood components inside and outside of cardiovascular system. Hemodynamic treatment in critical care is a quantitatively goal-oriented approach based on the theories of hemodynamics, according to the patient's real-time status and response to the intervention. Hemodynamic principles and concepts influence the choice and performance of treatment on shock. Firstly, flow indicator should be ensured the top priority at selecting feedback parameters for treatment. Meanwhile, be aware that, every hemodynamic indicator, so long as it is correctly measured, is of value in clinical practice. Secondly, the change of right heart function is of great importance in shock. Managing the right heart function has become an indispensible part in the treatment. Thirdly, the central venous pressure needs to be kept as low as possible in shock patients. Central venous pressure, which is different from the traditionally used pressure parameter instead of flow, is of significance in definitely guiding the treatment. Fourthly, critical hemodynamic therapy is not merely limited to supportive treatment, but encompasses the whole set of management of shock from etiology to prognosis.