ABSTRACT
Septic shock occasionally progresses to require increasingly aggressive treatment modalities. The paediatric intensive care unit patient has exhausted conventional therapy, including fluids, inotropy, antibiotic therapy and source control. The six-year-old child is suffering from neurogenic shock after a spinal cord injury, which is a form of distributive shock. This results in the complete loss of intravascular tone without accompanying tachycardia. After a fluid challenge, the optimal treatment of this patient is early administration of vasopressors. Dissociative shock represents an inability to deliver oxygen to the tissues. 'Cold' shock manifests as cool extremities and delayed capillary refill. Anaphylaxis is a form of distributive shock. The cardiorespiratory system is often deranged in shock states and an understanding of the basic concepts in cardiovascular physiology underpins most of the treatment decisions made in caring for patients with shock. Stroke volume is the volume of blood pumped from one ventricle of the heart with each beat.
