Kneyber Martin C J, van Heerde Marc, Henneveld Hetty Th
Beatrix Kinderziekenhuis/Universitair Medisch Centrum, afd. Kinderintensive Care, Groningen, The Netherlands.
Ned Tijdschr Geneeskd. 2010;154:A1195.
Paediatric shock is common. Hypovolaemic and septic shock are the main forms. Early and rapid results-oriented therapy of paediatric septic shock has a favourable effect on survival. There is an international guideline for the primary management of paediatric shock during the first hour after presentation of the patient. The goal of treatment is to prevent oxygen debt and consequently organ failure. The main symptoms of paediatric shock are tachycardia and reduced consciousness. In a child in shock, the clinical picture should be recognized within 15 minutes and an attempt should be made to reverse the situation by rapid fluid infusion. If the shock persists after 15 minutes, vasoactive medication should be given and the child should be transferred to a local paediatric intensive care unit. Intubation and mechanical ventilation are then also required.
小儿休克很常见。低血容量性休克和感染性休克是主要类型。对小儿感染性休克进行早期且快速的以结果为导向的治疗对生存率有积极影响。对于患儿就诊后第一小时内小儿休克的初始处理有国际指南。治疗目标是预防氧债并进而预防器官衰竭。小儿休克的主要症状是心动过速和意识减退。对于休克患儿,应在15分钟内识别临床症状,并尝试通过快速输液扭转局面。如果15分钟后休克仍持续,应给予血管活性药物,并将患儿转至当地儿科重症监护病房。随后还需要进行插管和机械通气。