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[Cardiac index, oxygen and serum lactate consumption in infants with hypovolemic and septic shock]
Insights
Pediatric hypovolemic shock shows low cardiac output (hypodynamic), while septic shock presents high cardiac output (hyperdynamic). Both conditions elevate serum lactate levels in infants.
Area of Science:
- Pediatric critical care medicine
- Hemodynamics
- Neonatal physiology
Context:
- Distinguishing between hypovolemic and septic shock in infants is crucial for appropriate management.
- Hemodynamic parameters and metabolic markers provide insights into shock states.
Purpose:
- To compare cardiac output, blood gases, and serum lactate levels in infants with hypovolemic versus septic shock.
- To characterize the hemodynamic profiles of these two shock types in pediatric patients.
Summary:
- Cardiac index was significantly lower in hypovolemic shock (1.88 L/min/m²) compared to septic shock (4.02 L/min/m²).
- Peripheral resistances were markedly higher in hypovolemic shock (3,079 dynes/min/cm⁵) than in septic shock (907 dynes/min).
- Both shock types exhibited elevated serum lactate levels (~4 mM), with differing oxygen consumption patterns.
Impact:
- Findings suggest hypodynamic shock in pediatric hypovolemia and hyperdynamic shock in sepsis, aligning with adult studies.
- This differentiation aids in understanding pathophysiological differences and guiding therapeutic strategies in pediatric shock.
Abstract:
Determination was made of cardiac output (using the stain dilution technique), gases in blood and serum lactate levels in eight infants with hypovolemic shock and sixteen with septic shock. The data were carried to indexes (values per square meter of body surface). In children with hypovolemic shock the cardiac index was 1.88 +/- 0.031/min/m,2 while in septic patients it was 4.02 +/- 1.011/min/m2. The peripheral resistances were 3,079 din/min/cm.5 in hypovolemic cases and 907 din/min in the septic. In both groups serum lactante levels rised close to 4 mM 61. Oxigen consumption was found low in hypovolemic patients and slightly high in the septic. It is concluded that our data are similar to those reported in similar studies in adults and hypodynamic shock is shown in hypovolemic patients, while hyperdynamic shock appears in septic cases.
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