What are the classes of hemorrhage? Hemorrhage is divided into four classes based on the amount of blood loss. Class I hemorrhage produces the least amount of blood loss, and class IV, the greatest. • Class I hemorrhage: The patient has lost up to 15% of his or her blood volume. Otherwise healthy patients are likely to …
Etiology of Shock in Children 1. Hypovolemia (not enough circulating volume to deliver oxygen and nutrients) 2. Impaired cardiac function (ineffective pumping of the circulating volume) 3. Inappropriate vasodilation (the circulating volume exists primarily in the venous capacitance system and is unavailable to deliver oxygen and nutrients)
How does isolated head trauma cause shock? In the absence of exsanguination from a large scalp laceration, it doesn’t. If a patient has shock after what appears to be isolated head trauma without obvious exsanguination from a scalp wound, there must be another explanation for the shock.
What are some ways in which trauma can cause shock? Posttraumatic hemorrhage is the most common way that trauma causes shock. Because young children have abdominal wall muscles that are poorly developed, they are at risk for liver and spleen injury after blunt abdominal trauma. In addition to hemorrhagic shock, blunt chest trauma can result …
Which is more important in the management of the child with septic shock: aggressive resuscitation at the referring hospital or excellent care at the tertiary care center? Although both are important, a recent study demonstrated that children in shock from sepsis who are aggressively resuscitated at the referring hospital have better outcomes than those who …
Important management of the child with septic shock Read More »
How the cascade of septic shock begins Most commonly, endotoxin (LPS) is bound by a plasma protein called LPS-binding protein (LBP). The LPS-LBP complex then binds to the CD14 receptor on the surfaces of macrophages. This process stimulates the formation of both tumor necrosis factor and interleukin. These two cytokines begin the cascade that leads …
Which of the cytokines is the most important? Tumor necrosis factor was once considered to be the most important of the cytokines. Although its formation seems to initiate and propagate the remainder of the inflammatory cascade, recent research on the cytokine pathway reveals it to be a tightly regulated balance among proinflammatory cytokines, anti-inflammatory cytokines, …