Pediatric Shock Part 5 Cardiogenic Shock

Cardiogenic Shock

·         Heart unable to pump blood effectively leading to decreased cardiac output

·         May be due to congenital heart diseases or myocarditis which decreases cardiac contractility

·         Occurs when tachycardia causes ineffective ventricular filling

·         Occurs when bradycardia causes insufficient forward flow of the blood

Causes

·         Congenital heart diseases

·         Myocarditis

·         Cardiomyopathies

·         Arrhythmias

·         Sepsis

·         Poisonings or drug toxicities

·         Myocardial injury

Cardiogenic Shock Symptoms

·         Tachypnea

·         Labored respirations

·         Tachycardia

·         Hypotension or near normal BP

·         Weak peripheral pulses

·         Delayed capillary refill

·         Pulmonary edema

·         Cyanosis

·         Cool, clammy skin

·         Changes in mental status

·         Oliguria

Note:   Tachypnea may be accompanied by increased respiratory effort as a result of the pulmonary edema

Management of Cardiogenic Shock

·         Administer fluid boluses cautiously

·         Give 5-10ml/kg isotonic crystalloids over 10-20 minutes

·         Administer supplemental oxygen

·         Assess for pulmonary edema

·         Obtain expert consultation

Source

Pediatric Advanced Life Support Provider Manual by Leon, M.D. Chameides, Ricardo A., M.D. Samson, Stephen M., M.D. Schexnayder and Mary Fran, RN Hazinski (Oct 12, 2011)