Peds shock and resuscitation

Question 1

Fick equation

Answer 1

DO2 = CAO2 x CO

Ox delivery = arterial O2 content x cardiac output

Question 2

Equation for cardiac output

Answer 2

CO = HR x SV

children more HR dependent due to myocardial immaturity

SV- mycoardial contractility, preload, afterload

(modify SVR to change preload/afterload; pharm interventions to alter contractility)

Question 3

Stages of shock

Answer 3

Compensated - neurohumoral responses preserve perfusion; may be reversible without intervention

Uncompensated- requires intervention

Irreversible shock = no response to therapeutic interventions

Question 4

Hypovolemic shock

Answer 4

• Most common cause of shock in kids, esp with dehydration

- loss of and/or decreased intake of fluid or hemorrhage

Question 5

Cardiogenic shock

Answer 5

pump failure resulting in decreased blood getting to the body

• Cardiac dysfunction or damage
  (i. e. congenital anomoly, post-op; infection/myocarditis, sepsis–infmammatory mediators; rhythm disturbances (SVT); Mechanical/trauma)

Mechanical/trauma = tamponade, Pulmonary embolism, pneumothorax

Question 6

Distributive shock

Answer 6

abnormal vasomotor tone leads to alteree flow distribution despite normal or high CO

• Sepsis
• Neurogenic
• Toxins (pharmacologic, chemicals)