The understanding and management of hypovolaemic shock has changed very little over the past 50
years with treatment requiring management of the causative lesion (i.e. surgical correction of blood loss)
and replacement of the intravascular volume by infusing blood and/or 0.9% sodium containing colloid or
crystalloid fluids. Due to recent developments in percutaneous coronary revascularisation techniques,
management of cardiogenic shock in some centers has changed. Emergency cardiac catheterisation with
urgent myocardial reperfusion (using percutaneous transluminal coronary angioplasty or coronary artery
stenting in selected cases) and use of glycoprotein IIb/IIIa antagonists while supporting the circulation
using an intra-aortic balloon pump, has been reported to reduce mortality of cardiogenic shock in acute
myocardial infarction. Large randomised, controlled multicentre trials are awaited