Principles of care for the patient in shock (pediatrics)

Shock is defined as a syndrome with inadequate tissue oxygenation. Therapeutic efforts therefore try to establish a balance between the supply and the actual need for oxygen. Oxygen consumption is reduced by intubation, mechanical ventilation, sedation, myorelaxation, control of hyperpyrexia. On the other hand the oxygen supply is increased by oxygen therapy with either non-invasive or invasive airway management.


 * CVP 5 to 10 cm H2O
 * PAWP 7 to 15 cm H2O
 * age-appropriate values MAP and PerP
 * CI 3 to 6 l/min/m2
 * SvcO2 > 70 %
 * O2ER < 30 %
 * minimization of myocardial damage – physiological standards of AST, troponin, CK-MB, ECG, echokardiography
 * adequate airiness of the lungs
 * lactate < 2 mmol/l

It is necessary to think about the possible complications of shock conditions:
 * ARDS
 * DIC
 * acute renal failure
 * acute liver failure
 * myocardial ischemia
 * edema of CNS
 * rhabdomyolysis
 * pancreatitis
 * sepsis
 * metabolic disorders

The aforementioned complications are a sign of the development of MODS (multiple organ dysfunction syndrom) and they significantly increase morbidity and mortality of the patients.

Zdroj

 * HAVRÁNEK, Jiří: Šok. (upraveno)

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Category:Patophysiology