medalphabetМедицинский алфавитMedical alphabet2078-56312949-2807ООО «Альфмед»10.33667/2078-5631-2026-11-51-65medalphabet-5086Research ArticleСтатьиПрикроватная ультрасонография при дифференциальной диагностике и персонифицированном лечении шока неясного генезаBedside ultrasonography in differential diagnosis and personalized treatment shock unknown originhttps://orcid.org/0009-0007-6152-1175ЖежукП. А.ZhezhukP. A.

Жежук Павел Александрови 

Москва

Zhezhuk Pavel A. 

Moscow 

pavel_zhezhuk@mail.ruhttps://orcid.org/0000-0003-4535-2563ВласенкоА. В.VlasenkoA. V.

Власенко Алексей Викторович 

Москва

Vlasenko Alexey V. 

Moscow 

dr.vlasenko67@mail.ruhttps://orcid.org/0000-0002-3614-6971ЛевиковД. И.LevikovD. I.

Левиков Дмитрий Ильич 

Москва

Levikov Dmitry I. 

Moscow 

dmitry248@mail.ruhttps://orcid.org/0000-0002-3852-8877РодионовЕ. П.RodionovE. P.

Родионов Евгений Петрович 

Москва

Rodionov Evgeniy P. 

Moscow 

dr.rodionov@gmail.comЕвдокимовЕ. А.EvdokimovE. A.

Евдокимов Евгений Александрович 

Москва

Evdokimov Evgeniy A. 

Moscow 

ea_evdokimov@mail.ruhttps://orcid.org/0000-0002-7263-0058МаковейВ. И.MakoveyV. I.

Маковей Виктория Ивановна 

Москва

Makovey Victoria I.

Moscow 

ГБУЗ «Московский многопрофильный научно-клинический центр имени С.П. Боткина Департамента здравоохранения города Москвы ; Кафедра анестезиологии, реаниматологии и неотложной медицины ФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования» Минздрава РоссииРоссияS.P. Botkin Moscow Multidisciplinary Scientific and Clinical Center (Botkin hospital) ; Department of Anesthesiology, Resuscitation and Emergency Medicine, Russian Medical Academy of Continuing Professional EducationRussian FederationГБУЗ «Московский многопрофильный научно-клинический центр имени С.П. Боткина Департамента здравоохранения города МосквыРоссияS.P. Botkin Moscow Multidisciplinary Scientific and Clinical Center (Botkin hospital) ; Department of Anesthesiology, Resuscitation and Emergency Medicine, Russian Medical Academy of Continuing Professional EducationRussian FederationКафедра анестезиологии, реаниматологии и неотложной медицины ФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования» Минздрава РоссииРоссияDepartment of Anesthesiology, Resuscitation and Emergency Medicine, Russian Medical Academy of Continuing Professional EducationRussian Federation202604062026111Кардиология. Неотложная медицина (1)5165Copyright © Жежук П.А., Власенко А.В., Левиков Д.И., Родионов Е.П., Евдокимов Е.А., Маковей В.И., 20262026Жежук П.А., Власенко А.В., Левиков Д.И., Родионов Е.П., Евдокимов Е.А., Маковей В.И.Zhezhuk P.A., Vlasenko A.V., Levikov D.I., Rodionov E.P., Evdokimov E.A., Makovey V.I.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-alphabet.com/jour/article/view/5086

Артериальная гипотензия и шок не ясного генеза являются частой причиной госпитализации пациентов в отделение реанимации, характеризуются большими фармакоэкономическими затратами и высокой летальностью. Эффективность лечения пациентов с шоком определяется своевременным и правильным выявлением ведущих причин его развития и реализацией персонифицированной терапии. Дифференциальная диагностика шока часто возможна при анализе клинических, лабораторных и не инвазивных инструментальных данных. Эхокардиография сегодня является незаменимым инструментом для ургентной и плановой оценки состояния сердечно- сосудистой системы, которая позволяет быстро получить информацию об анатомии, физиологии и причинах развития сердечно- сосудистой недостаточности. Использование качественных, опирающихся только на 2D-визуализацию методов ультрасонографии существенно расширяет диагностические возможности. Однако для точной диагностики требуется использование более продвинутых, полуколичественных или количественных методов ультрасонографии, которые помогут выявить ведущие механизмы патогенеза шока, что позволит клиницисту реализовать персонализированный принцип лечении данного контингента пациентов.

Arterial hypotension and shock of unknown origin are common reasons for intensive care unit admissions and are characterized by significant pharmacoeconomic costs and high mortality. The effectiveness of treatment for patients with shock is determined by the timely and accurate identification of the underlying causes and the implementation of personalized therapy. Differential diagnosis of shock is often possible through the analysis of clinical, laboratory, and non-invasive instrumental data. Echocardiography is now an indispensable tool for urgent and routine assessment of the cardiovascular system, providing rapid information on the anatomy, physiology, and causes of cardiovascular failure. The use of high-quality ultrasonography methods, based solely on 2D visualization, significantly expands diagnostic capabilities. However, accurate diagnosis requires the use of more advanced, semi- quantitative or quantitative ultrasonography methods to identify the underlying mechanisms of shock pathogenesis, allowing the clinician to implement personalized treatment for this patient population.

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The authors declare that there are no conflicts of interest present.