General approach to shock

The hemodynamic alterations in elderly individuals when combined with their reduced functional capacity concerning specific organ systems places them at an increased risk of developing shock with certain disease processes. The initial management should be directed toward shock resuscitation with appropriate volume and/or vasopressor/inotropic support. Then attention must be given to identifying and treating the underlying causes and the pathophysiologic mechanisms involved in the shock. Monitoring the adequacy of the treatment is important and can be done by sequential measurement of various parameters such as O2 delivery, O2 consumption, lactate levels, and gastric intramucosal pH.