All are true about septic shock in children except –
Correct Answer: Heart rate remains same
Description: Septic shock in children
Septic shock is an inflammatory state resulting from a systemic response to bacterial infection.
The decrease in peripheral resistance (vasodilatation) is the hallmark of early (hyper dynamic) stage of septic shock, this feature distinguishes it from other types of shock. Decreased peripheral resistance (vasodilatation) leads to a compensatory increase in cardiac output; therefore, cardiac output is maintained or some time increased despite of shock.
Decreased peripheral resistance and increased cardiac output lead to increased blood flow and total oxygen delivery to the tissue. But, still, the tissues lack O2 due to local microcirculatory changes produced as a result of sepsis which causes decrease tissue extraction of oxygen. So, increased blood flow and cardiac out are still inadequate to meet the total metabolic needs of the tissue which are increased in sepsis.
As sepsis progresses, hypo dynamic stage supervenes in which there is decreased cardiac output and increased peripheral resistance.
So, hemodynamic changes in septic shock occur in two characteristic patterns, Early hyperdynamic and late hypo dynamic shock
1) Early hyperdynamic shock
Hypotension is a late feature of septic shock and early hyperdynamic stage is characterized by normal or increased BR
Other features are : -
Tachycardia
Normal or increased cardiac output
Tachypnea
Warm extremities
Decreased systemic vascular resistance
Increased pulmonary vascular resistance
2) Late hypo dynamic stage
Decreased cardiac output
Hypotension
Increased vascular resistance
Cool, mottled and often cyanotic extremities
Oliguria, renal failure
Hypothermia
Category:
Pediatrics
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