Pediatric shock overview | ACLS-Algorithms.com

Comments

  1. Sonny Yates says

    Jeff,
    I am confused about some things. I would appreciate your help
    1) Would it be fair to say that in distributive shock pulse pressure is usually wide to begin with as vasodilation causes the DBP to drop while the SBP generally stays the same at least early?
    2) As the compensation factors begin to fail that wide PP then narrows as SBP falls to meet the DBP?
    3) Can you tell me why one uses nor-epi instead of epi. I find confusing and sometimes contradictory information when I look that up.
    Thanks Jeff,
    Sonny Yates

    • ACLS says

      Statement #1 is correct. (you probably will see a drop in systolic blood pressure, but there will still be a widening pulse pressure.)

      Statement #2 is correct.

      3. Norepinephrine has very selective vasoconstrictive affects while not affecting heart rate, stroke volume, and other cardiovascular aspects. When you are dealing with distributive shock in the late stages, you only want vasoconstriction. Norepinephrine provides this. Epinephrine can provide this, but it comes with beta adrenergic affects of increased heart rate and stroke volume which can lead to other problems in late stages of distributive shock.

      I hope that makes sense.

      Kind regards,
      Jeff

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