Shock States

Smith, Lincoln; Hernan, Lynn J.

doi:10.1016/b978-0-323-07307-3.10029-1

Cited by 4 publications

(3 citation statements)

References 125 publications

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“…Shock is a clinical syndrome in which the effective circulating blood volume is reduced and the microcirculation perfusion of important organs is insufficient, leading to the dysfunction of all the organs. Circulatory dysfunction leads to tissue hypoxia and insufficient nutrition supply, which leads to cell dysfunction and eventually cell death (Smith and Herman, 2001).…”

Section: Discussionmentioning

confidence: 99%

“…In septic shock patients, fluid resuscitation and the reduction of fluid balance under the guidance of SV is associated with clinical outcomes (Sankar et al, 2017). SV monitoring in fluid resuscitation can reduce the fluid load, shorten the time of mechanical ventilation, shorten the time of using vasoactive drugs, and reduce the probability of hemodialysis (Smith and Herman, 2001).…”

Section: Discussionmentioning

confidence: 99%

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The value of early hemodynamic parameters in neonates with septic shock

Madukwe¹,

Ndugbu²

2021

J. Public Health Dis.

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This study aims at determining the value, if any, of hemodynamic parameters in early septic shock incidence among the neonatal population. Eighty-two neonates with septic shock were divided into “survivors” and “non-survivors” according to their survival status within 4 weeks (28-days). The differences in stroke volume (SV), cardiac output (CO), cardiac index (CI) and systemic vascular resistance index (SVRI) were compared between survivors and non-survivors. Receiver operating characteristic (ROC) curves for 28-day mortality were constructed to compare the area under the curve (AUC) among SV, CO and CI. The test characteristics of the different cut-off values, including sensitivity, specificity, area under the ROC curve (AUC), positive likelihood and negative likelihood ratio were equally examined. Of 82 cases of neonates with septic shock in this study, 52 were survivors and 30 non-survivors. The hemodynamic parameters of SV, CO and CI were higher in survivors than in non-survivors (all p < 0.05). The AUC values of SV, CO and CI to predict 28-day mortality were 0.724, 0.742, and 0.729, respectively. Stroke volume had sensitivity, specificity, PPV, and NPV of 75.0, 75.0, 40.9 and 92.9%, respectively. Cardiac output had sensitivity, specificity, PPV, and NPV of 91.7, 55.7, 67.6 and 96.7%, respectively. CI had sensitivity, specificity, PPV, and NPV of 91.7, 67.3, 60.7 and 97.2%, respectively. CO achieved the highest AUC, sensitivity and PPV. In conclusion, SV, CO and CI may be valuable in the early stage of septic shock among the neonates.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The value of early hemodynamic parameters in neonates with septic shock

Madukwe¹,

Ndugbu²

2021

J. Public Health Dis.

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“…As for relative adrenal insufficiency, it is diagnosed if basal cortisol level is >20 g/dl and ACTH response increment increase in cortisol ≤9 g/dl 68 . It should be suspected in patients with refractory shock and history of trauma (head or abdominal), sepsis, central nervous system disease, Waterhouse-Friedrickson syndrome, treatment with etomidate, or steroid use in the 6 months prior to presentation 69 . In a cohort analysis by Zimmerman et al, children who received corticosteroids had no improvement in mortality, days of vasoactive-inotropic infusion, days of mechanical ventilation, change in pediatric overall performance category score, PICU and hospital length of stay 70 .…”

Section: Treatment Of Shockmentioning

confidence: 99%

Advances in Monitoring and Management of Shock

Mtaweh

Trakas

et al. 2013

Pediatric Clinics of North America

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Synopsis Shock continues to be the proximate cause of death for many childhood diseases and imposes a significant burden. Early recognition and treatment of pediatric shock, regardless of etiology, decreases mortality and improves outcome. In addition to the conventional parameters (e.g., heart rate (HR), systolic blood pressure (SBP), urine output (UOP), and central venous pressure (CVP)), biomarkers and non-invasive methods of measuring cardiac output are now available to monitor and treat shock. In this article, we emphasize how fluid resuscitation is the cornerstone of shock resuscitation although the choice and amount of fluid may vary based on the etiology of shock. Other emerging treatments for shock i.e., temperature control, extracorporeal membrane oxygenation (ECMO)/Ventricular Assist Devices (VAD) are also discussed briefly in this article.

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Role of vasopressin and terlipressin in refractory shock compared to conventional therapy in the neonatal and pediatric population: a systematic review, meta-analysis, and trial sequential analysis

et al. 2017

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BackgroundVasopressin (AVP) and terlipressin (TP) have been used as last-line therapy in refractory shock in children. However, the efficacy and safety profiles of AVP and TP have not been determined in pediatric refractory shock of different origins. We aimed to assess the efficacy and safety of the addition of AVP/TP therapy in pediatric refractory shock of all causes compared to conventional therapy with fluid resuscitation and vasopressor and inotropic therapy.MethodsWe conducted a systematic review, meta-analysis, and trial sequential analysis (TSA) comparing AVP and TP to conventional therapy. MEDLINE, EMBASE, Cochrane Library, and ClinicalTrials.gov were searched up to February 2016. The systematic review included all reports of AVP/TP use in the pediatric population. Reports of clinical trials were pooled using random-effects models and TSA. Main outcomes were mortality and tissue ischemia.ResultsThree randomized controlled trials and five “before-and-after clinical” trials (without comparator) met the inclusion criteria. Among 224 neonates and children (aged 0 to 18 years) with refractory shock, 152 received therapy with AVP or TP. Pooled analyses showed no association between AVP/TP treatment and mortality (relative risk (RR),1.19; 95% confidence interval (CI), 0.71–2.00), length of stay in the pediatric intensive care unit (PICU) (mean difference (MD), –3.58 days; 95% CI, –9.05 to 1.83), and tissue ischemia (RR, 1.48; 95% CI, 0.47–4.62). In TSA, no significant effect on mortality and risk for developing tissue ischemia was observed with AVP/TP therapy.ConclusionOur results emphasize the lack of observed benefit for AVP/TP in terms of mortality and length of stay in the PICU, and suggest an increased risk for ischemic events. Our TSA suggests that further large studies are necessary to demonstrate and establish benefits of AVP/TP in children.PROSPERO registry: CRD42016035872Electronic supplementary materialThe online version of this article (doi:10.1186/s13054-016-1589-6) contains supplementary material, which is available to authorized users.

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Shock States

Cited by 4 publications

References 125 publications

The value of early hemodynamic parameters in neonates with septic shock

The value of early hemodynamic parameters in neonates with septic shock

Advances in Monitoring and Management of Shock

Role of vasopressin and terlipressin in refractory shock compared to conventional therapy in the neonatal and pediatric population: a systematic review, meta-analysis, and trial sequential analysis

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