What blood pressure defines shock in children?
Shock is not defined by the blood pressure or by any other vital sign. Shock exists when the patient’s metabolic demand exceeds the body’s ability to deliver oxygen and nutrients. This occurs most commonly when metabolic demand is normal or slightly elevated but delivery of oxygen and nutrients is dramatically reduced. Examples include excessive blood or fluid volume loss (hemorrhage or diarrhea), poor cardiac function, and sepsis. The shock state can and often does exist in the presence of a “normal” blood pressure.
- 1. Shock is a condition in which the patient’s metabolic requirements are unmet.
- 2. The shock state is a complex interplay between the physiologic insult and the host’s response to that insult; both play a role.
- 3. In its earliest phase, shock might be recognized only by abnormal results of laboratory tests that measure tissue acid-base status (e.g., serum lactate). Overt clinical signs are seen as the shock state progresses.
Bell LM: Shock. In Fleisher GM, Ludwig S, Henretig FM (eds): Textbook of Pediatric Emergency Medicine, 6th ed. Philadelphia, Lippincott Williams & Wilkins, 2010, pp 46-57.