USE OF POCUS IN THE MANAGEMENT OF CARDIOGENIC SHOCK: ADVANCES IN HEMODYNAMIC ASSESSMENT AND THERAPEUTIC OPTIMIZATION

Abstract

 Cardiogenic shock is one of the most severe cardiovascular emergencies and remains associated with high rates of morbidity and mortality despite significant advances in contemporary therapeutic strategies. In this context, point-of-care ultrasound (POCUS) has become an important complementary tool for hemodynamic assessment, enabling rapid bedside evaluation and supporting diagnosis, monitoring, and therapeutic decision-making in critically ill patients. This study aimed to analyze, through an integrative literature review, the current evidence regarding the use of POCUS in the management of cardiogenic shock, with emphasis on hemodynamic assessment, diagnosis of cardiovascular dysfunction, monitoring of therapeutic response, and optimization of clinical management. An integrative literature review with a qualitative and descriptive approach was conducted. The bibliographic search was performed in June 2026 using the PubMed/MEDLINE, SciELO, ScienceDirect, and Cochrane Library databases. Publications, preferably from the last ten years, including clinical trials, observational studies, systematic reviews, meta-analyses, expert consensus statements, and international guidelines addressing the use of POCUS in cardiogenic shock were considered. The analyzed evidence demonstrated that the integration of focused cardiac ultrasound, lung ultrasound, and venous congestion assessment improves the understanding of the pathophysiology of cardiogenic shock, enhances dynamic cardiovascular monitoring, and supports individualized therapeutic strategies. However, the effectiveness of POCUS depends on adequate operator training, standardized examination protocols, and the integration of ultrasonographic findings with clinical assessment and complementary diagnostic methods. In conclusion, POCUS represents a complementary tool of substantial clinical relevance in the management of cardiogenic shock, contributing to more accurate hemodynamic assessment and optimization of care for critically ill patients. Nevertheless, additional prospective studies are required to strengthen the evidence regarding its impact on clinically relevant outcomes.