All are true about septic shock in children except ?

Ans. is c' i.e., Hea rate remains same Septic shock in children Septic shock is an inflammatory state resulting from systemic response to bacterial infection. o Decrease in peripheral resistance (vasodilatation) is the hallmark of early (hyperdynamic) stage of septic shock, this feature distinguishes it from other types of shock. Decreased peripheral resistance (vasodilatation) leads to compensatory increase in cardiac output; therefore, cardiac output is maintained or some time increased despite of shock. o Decreased peripheral resistance and increased cardiac output leads to increased blood flow and total oxygen delivery to the tissue. But, still the tissues lack 02 due to local microcirculatory changes produced as a result of sepsis which causes decrease tissue extraction of oxygen. So, increased blood flow and cardiac out are still inadequate to meet the total metabolic needs of the tissue which are increased in sepsis. o As sepsis progresses, hypodynamic stage supervenes in which there is decreased cardiac output and increased peripheral resistance. So, hemodynamic changes in septic shock occur in two characteristic patterns, Early hyperdynamic and late hypodynamic shock 1) Early hyperdynamic shock Hypotension is a late feature of septic shock and early hyperdynamic stage is characterized by normal or increased BP Other features are : ? o Tachycardia o Warm extremities o Normal or increased cardiac output o Decreased systemic vascular resistance o Tachypnea o Increased pulmonary vascular resistance 2) Late hypodynamic stage o Decreased cardiac output o Cool, mottled and often cyanotic extremities o Hypotension o Oliguria, renal failure o Increased vascular resistance o Hypothermia