Aspects of Shock in Childhood
Shock, the acute failure of the circulation to deliver adequate oxygen and nutrients to the tissues, may occur at any age. Although children do not have to contend with degenerative conditions of the cardiovascular system, they do appear to be at some disadvantage. In infancy cardiac output is more rate dependent, with infants unable to respond to bradycardia with an adequate increase in stroke volume although they are able to tolerate tachycardia . Myocardial contractility is probably less efficient in infancy with less contractile tissue per unit of myocardium  thus reducing the capacity for an inotropic response. Further infants and young children are predisposed to hypovolemia, the proportion of an infants body consisting of water being 80% rather than 60%. In addition, in infancy a greater proportion of this water is extracellular  and in young children the pulmonary vasculature is more labile and pulmonary hypertension may develop more easily.
KeywordsSeptic Shock Disseminate Intravascular Coagulation Hemorrhagic Shock Adult Respiratory Distress Syndrome Toxic Shock Syndrome
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