[Pathogenesis and therapy of shock in children (author's transl)]

Abstract

The severely disturbed microcirculation characteristic of any type of shock leads to typical functional impairments in vital organs such as heart, brain, lungs, liver, kidneys and gut which, in turn, exert an adverse influence upon the process of shock. The insufficient circulation primarily of the gut and the liver causes even those forms of shock which are not initially triggered by endotoxin to develop into the ominous endotoxin shock unless rapid and effective therapy interrupts this vitious circle. The prognosis of shock depends on early diagnosis nad treatment. Therapy should be initiated even before diagnosis of the underlying disease has been completed. The following therapeutic factors require special consideration: Volume substitution, prevention of cardial decompensation and of impending uremia, prevention and treatment of respiratory failure, direct treatment of the disturbed microcirculation by means of peripherally vasodilating drugs and if necessary, suppression of the intravascular coagulation by means of plateled aggregation inhibiting, anticoagulant and fibrinolytic drugs.