<![CDATA[Obstructive shock is a life-threatening condition caused by a mechanical obstruction of blood flow, one of the important causes being tension pneumothorax (TP). Increased intrapleural pressure in TP causes lung collapse, impaired venous return, decreased cardiac output, hypotension, and tissue hypoperfusion. This literature review aimed to evaluate the mechanisms of obstructive shock caused by TP, its clinical manifestations, diagnosis, management, and complications associated with decompression. This study used a Literature Review method with a Narrative Review design based on national and international journals, ClinicalKey, textbooks, and proceedings published from 2020 to 2026. Relevant literature available in full text and discussing TP and obstructive shock was analyzed descriptively. The review showed that TP can cause respiratory and hemodynamic disturbances, including respiratory distress, hypoxemia, tachycardia, diminished breath sounds, hypotension, and hemodynamic instability. Increased intrathoracic pressure impairs venous return and increases pulmonary vascular resistance, resulting in decreased preload, cardiac output, and organ perfusion. Immediate decompression is the primary treatment to relieve the obstruction and restore hemodynamic stability. The success of decompression is influenced by appropriate indications, insertion site, needle length, technique, and patient anatomical characteristics. Failed decompression may result in persistent hemodynamic compromise, while complications may include catheter dislodgement, iatrogenic pneumothorax, vascular injury, and the need for repeat decompression. Therefore, early recognition of TP and obstructive shock, followed by prompt and appropriate decompression, is essential to prevent clinical deterioration and improve patient outcomes.]]>
