Shock in children
- Author:
Davendralingam Sinniah
- Publication Type:Review
- Keywords:
shock, child, aetiology, treatment, management
- From:International e-Journal of Science, Medicine and Education
2012;6(supp1):S129-S136
- CountryMalaysia
- Language:English
-
Abstract:
Shock, a major cause of morbidity and
mortality in children, is the the most anxiety-provoking
emergency that needs to be addressed urgently and
effectively by the attending paediatrician. It is a state
where the metabolic demands of the tissue are not met due
to circulatory dysfunction. Unlike adults, hypotension is
a very late feature of shock in children. As the child’s
condition worsens, the clinical presentation of the
different causes of shock become similar, and nullify
any aetiological differences. Regardless of the type of
shock, the final common pathway is inadequate tissue
perfusion and oxygen supply to meet cellular demands.
Delayed recognition and treatment result in progression
from compensated reversible shock to uncompensated
irreversible shock with widespread multiple system
organ failure to death. This paper reviews the
physiological basis, and pathophysiological classification
of the various types of shock and their respective
aetiologies. The clinical features of the different types
of shock are described, and current diagnostic and
therapeutic strategies are applied for the most effective
and appropriate treatment for resuscitating the child in
shock. A strong index of suspicion, early recognition,
timely intervention and transfer to an intensive care unit
are critical for successful outcomes in the management
of paediatric shock.
- Full text:W020150928582336382634.pdf