Neonatal shock

This review discusses the literature on neonatal shock published in 1993. Etiologies for shock including the role of enterotoxins in sudden infant death syndrome and the role of Streptococcus pyogenes in streptococcal toxic shock syndrome are discussed. The monitoring of cardiac function, oxygen consumption, and oxygen delivery in neonates with shock and in children after cardiac surgery are discussed. The physiology of shock including the metabolic and cytokine mediator responses to shock are outlined, and the various new treatment modalities are compared. These include conventional inotropic therapy, extracorporeal membrane oxygenation, and cytokine manipulation.