Physiology and classification of shock in children
- Wendy J Pomerantz, MD, MS
Wendy J Pomerantz, MD, MS
- Co-Director, Injury Free Coalition of Greater Cincinnati
- Professor of Clinical Pediatrics
- Cincinnati Children's Hospital Medical Center
- Mark G Roback, MD
Mark G Roback, MD
- Professor, Department of Pediatrics
- University of Minnesota Medical School
- Section Editor
- Susan B Torrey, MD
Susan B Torrey, MD
- Section Editor — Pediatric Resuscitation; Pediatric Trauma
- Director, Division of Pediatric Emergency Medicine
- Associate Professor of Emergency Medicine and Pediatrics (Clinical)
- NYU School of Medicine
- Deputy Editor
- James F Wiley, II, MD, MPH
James F Wiley, II, MD, MPH
- Senior Deputy Editor — Adult and Pediatric Emergency Medicine
- Senior Deputy Editor — Primary Care Sports Medicine (Adolescents and Adults)
- Professor of Pediatrics and Emergency Medicine/Traumatology
- University of Connecticut School of Medicine
This topic will review the physiologic determinants and classification of shock. The initial evaluation and management of shock in children, in general, and hypovolemic and septic shock, specifically, are discussed separately. (See "Initial evaluation of shock in children" and "Initial management of shock in children" and "Hypovolemic shock in children: Initial evaluation and management" and "Systemic inflammatory response syndrome (SIRS) and sepsis in children: Definitions, epidemiology, clinical manifestations, and diagnosis".)
Shock is a physiologic state characterized by a significant, systemic reduction in tissue perfusion, resulting in decreased tissue oxygen delivery. Although the effects of inadequate tissue perfusion are initially reversible, prolonged oxygen deprivation leads to generalized cellular hypoxia and derangement of critical biochemical processes, including [1,2]:
●Cell membrane ion pump dysfunction
●Leakage of intracellular contents into the extracellular space
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