- Respiratory failure, shock, and cardiopulmonary arrest in children require timely intervention
- Shock: A physiologic mismatch of metabolic supply and demand leading to tissue hypoxia and multisystem organ failure
- Early recognition and treatment of respiratory insufficiency and shock can prevent progression to cardiopulmonary arrest
- Respiratory failure leading to pulseless electrical activity (PEA) and then asystole is the most common cause of cardiopulmonary arrest in children, although cardiac and traumatic causes are not uncommon
- Asystole is the presenting rhythm in 2/3 of pediatric cardiopulmonary arrest; ventricular fibrillation and tachycardia are rare, occurring mostly in adolescents and children with congenital heart disease
- Shock can be subcategorized into 4 overlapping types:
- Hypovolemic: Inadequate circulating volume (e.g., hemorrhage or abnormal intake/output)
- Distributive: Decreased systemic vascular resistance leading to inappropriate peripheral blood distribution (e.g., sepsis)
- Cardiogenic: Impairment of myocardial function (e.g., myocarditis)
- Obstructive: Obstructed cardiac filling and output (e.g., pulmonary embolism)
- Children in septic shock may present with “warm shock” (high cardiac output, low systemic vascular resistance) or “cold shock” (low cardiac output, high systemic vascular resistance)
- Compensated shock occurs when normal blood pressure is maintained through increased heart rate, vascular resistance, inotropy, and venous tone. This may progress to late, uncompensated shock if intervention is not timely and aggressive
- Hypotensive shock may rapidly progress to cardiopulmonary failure/arrest
There's more to see -- the rest of this topic is available only to subscribers.
Schaider, Jeffrey J., et al., editors. "Resuscitation, Pediatric." 5-Minute Emergency Consult, 5th ed., Lippincott Williams & Wilkins, 2016. Emergency Central, emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307075/all/Resuscitation_Pediatric.
Resuscitation, Pediatric. In: Schaider JJJ, Barkin RMR, Hayden SRS, et al, eds. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2016. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307075/all/Resuscitation_Pediatric. Accessed June 2, 2023.
Resuscitation, Pediatric. (2016). In Schaider, J. J., Barkin, R. M., Hayden, S. R., Wolfe, R. E., Barkin, A. Z., Shayne, P., & Rosen, P. (Eds.), 5-Minute Emergency Consult (5th ed.). Lippincott Williams & Wilkins. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307075/all/Resuscitation_Pediatric
Resuscitation, Pediatric [Internet]. In: Schaider JJJ, Barkin RMR, Hayden SRS, Wolfe RER, Barkin AZA, Shayne PP, Rosen PP, editors. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2016. [cited 2023 June 02]. Available from: https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307075/all/Resuscitation_Pediatric.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Resuscitation, Pediatric ID - 307075 ED - Barkin,Adam Z, ED - Shayne,Philip, ED - Rosen,Peter, ED - Schaider,Jeffrey J, ED - Barkin,Roger M, ED - Hayden,Stephen R, ED - Wolfe,Richard E, BT - 5-Minute Emergency Consult UR - https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307075/all/Resuscitation_Pediatric PB - Lippincott Williams & Wilkins ET - 5 DB - Emergency Central DP - Unbound Medicine ER -