Introduction
Introduction
Shock is a severe condition that can rapidly progress into cardiac arrest if it is not treated, especially in critically ill children. Poor outcomes are likely if a patient in shock further deteriorates into cardiac arrest.
Key Takeaway
Blood pressure does NOT define shock. The child in shock can have a blood pressure that is normal, decreased, or increased.
This section presents:
- The pathophysiology of shock
- The effect of different types of shock on the patient’s blood pressure
- A scale to grade the severity of shock based on the patient’s systolic blood pressure
- Signs of the four most common types of shock
- A systematic approach to the evaluation of the cardiovascular system
Shock is a medical condition in which poor tissue perfusion causes organs, especially the brain, heart, liver, and kidneys, to fail due to inadequate oxygenation and failure to sustain the body’s metabolic demands. Tissue hypoxia, anaerobic metabolism, and accumulation of lactic acid and carbon dioxide may cause irreversible cell damage and organ failure.
Shock can be due to compromised cardiac function causing low ejection fraction as seen in cardiogenic and hypovolemic shock. It can also be due to increased cardiac output, as seen in sepsis and anaphylactic shock. The goal of treating shock is to improve systemic perfusion and oxygen delivery to halt the progression of end-organ injury, cardiopulmonary failure, and cardiac arrest.