The objectives of this review are to discuss the clinical assessment, pathophysiology, and management of shock, with an emphasis on circulatory physiology, cardiopulmonary interactions, and pharmacologic strategies to optimize systemic oxygen delivery. These principles will then be applied to the clinical syndromes of heart failure and cardiogenic shock that are seen in children.
An understanding of essential circulatory physiology and the pathophysiology of shock are necessary for managing patients at risk for or in a state of shock. A timely and accurate assessment of cardiac function, cardiac output, and tissue oxygenation and the means by which to enhance the relationship between oxygen delivery and consumption are essential in order to optimize outcomes.
1Department of Pediatrics, Critical Care Medicine and Cardiology, Baylor College of Medicine, Texas Children’s Hospital, Houston, TX.
2Department of Pediatrics, Critical Care Medicine and Cardiology, University of Mississippi Medical Center, Batson Children’s Hospital, Jackson, MS.
3Department of Pediatrics, Critical Care Medicine, University of Washington School of Medicine, Seattle Children’s Hospital, Seattle, WA.
The authors have disclosed that they do not have any potential conflicts of interest.
For information regarding this article, E-mail: Bronicki@bcm.edu