Published online Jul 31, 2019. doi: 10.5492/wjccm.v8.i4.36
Peer-review started: March 11, 2019
First decision: April 16, 2019
Revised: May 14, 2019
Accepted: June 12, 2019
Article in press: June 12, 2019
Published online: July 31, 2019
Evaluating and managing circulatory failure is one of the most challenging tasks for medical practitioners involved in critical care medicine. Understanding the applicability of some of the basic but, at the same time, complex physiological processes occurring during a state of illness is sometimes neglected and/or presented to the practitioners as point-of-care protocols to follow. Furthermore, managing hemodynamic shock has shown us that the human body is designed to fight to sustain life and that the compensatory mechanisms within organ systems are extraordinary. In this review article, we have created a minimalistic guide to the clinical information relevant when assessing critically ill patients with failing circulation. Measures such as organ blood flow, circulating volume, and hemodynamic biomarkers of shock are described. In addition, we will describe historical scientific events that led to some of our current medical practices and its validation for clinical decision making, and we present clinical advice for patient care and medical training.
Core tip: In this review, we depict the historical understanding of circulation and blood flow physiology. Also, by characterizing the different approaches to circulatory failure, we attempt to provide a simplified tool for education and one summarized clinical guideline for management in the critical care unit.