Pediatric Shock: An Overview

Derek S. Wheeler1, 2, *, Rajit K. Basu2
1 Division of Critical Care Medicine, Cincinnati Children’s Hospital Medical Center, USA
2 Division of Critical Care Medicine, Cincinnati Children’s Hospital Medical Center, USA

© 2013 Wheeler and Basu

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the University of Cincinnati College of Medicine, Clinical Director, Division of Critical Care Medicine, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH 45229-3039, USA; Tel: (513) 636-4259; Fax: (513) 636-4267; E-mails:


Shock is one of the most frequently diagnosed, yet poorly understood disorders in the pediatric intensive care unit (PICU). The very definition of what constellation of physical signs and symptoms that comprise shock remains controversial, in part due to the vast array of disorders that cause shock in critically ill and injured children. Early management and reversal of the shock state is associated with significantly improved outcomes. However, early management is critically dependent upon the early recognition and diagnosis of shock at the bedside. Failure to recognize the signs and symptoms of shock and to institute timely and appropriate care leads to higher mortality rates in both children and adults. Clinical recognition of shock requires a high index of suspicion – as such, all pediatric health care providers should be cognizant of the clinical presentation, pathophysiology, and early management of shock.

Keywords: Shock, children, critical illness, oxygen delivery, sepsis.