Published: 2021-04-27

A prospective observational study on assessment of types of shock in children and requirement of inotropes in treatment of shock in tertiary care hospital

Jhansi Rani Kotha, Hari Krishna Kothapally, Sai Chand Pinnoju, Sudheer Kumar


Background: Shock is a state of impaired tissue perfusion which result in an imbalance between oxygen demand and supply. This reduction in effective tissue perfusion causes insufficient or improper delivery and distribution of oxygen and nutrients. There is sparse date regarding epidemiology of shock in paediatrics. In this study we were aimed to assess the types of shock and treatment of shock with Inotropes.

Methods: Children of age 1 month to 12 years with a clinical diagnosis of shock were included.

Results: Out of 155 children admitted with shock 72.2% had septic shock, 25.8% had hypovolemic shock, 1.2% had cardiogenic shock, 0.6% had dengue shock. In this study the mortality rate was 8.39% of total patients. The mortality rate of septic shock, hypovolemic shock, cardiogenic shock was 84%, 7.69%, 7.69% respectively. 74.33% of patients were treated with two Inotropes, 5.3% were treated with more than two Inotropes, 11.5% were treated with single Inotropes and 0.88% was treated with no inotrope.

Conclusions: In the present study, among all types of shock the prevalence and mortality rate was more with Septic shock. As shock has high mortality rate in children the early recognition and patient education is required.


Hypovolemic shock, Septic shock, Cardiogenic shock, Dengue shock, Inotropes, Mortality

Full Text:



Sethuram U, Bhaya N. Paediatric shock. Children’s hospital of Michigan, Division of Emergency Medicine, Carman and Ann Adams Department of Paediatrics, 3901 Beaubien Boulevard, Detroit, MI48201, USA. 2008;405-23.

Mohan H. In: Derangements of Homeostasis and Haemodynamics, Shock. Textbook of Pathology, 2010, 6th Edition, Jaypee Brother Medical Publishers (p) Ltd, Jitendar P Vij. Chapter 5;108-113.

Sinniah D. Shock in children, Review Article, Paediatrics, Clinical School, International Medical University, Jaln Rasah, 70300 Seremban, Negeri Sembilan DK, MALAYSIA, IeJSME. 2012;6(1): S129-S136.

Brierley J, Carcillo JA, Choong K, Cornell T, Decaen A, Deymann A et al. Clinical practice parameters for hemodynamic support of paediatric and neonatal septic shock: 2007 update from the American College of Critical Care Medicine. Crit Care Med. 2009;37(2):666-88.

Harris PA, Taylor R, Thielke R, Payne J, Gonzalez N, Conde JG. Research electronic data capture (REDCap): A metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform. 2009;42(2):377-81.

Gobinathan S, Kannan KS. Study of prevalence, etiology, response to treatment and outcome of paediatric shock in a tertiary care hospital. Int J Contemp Pediatr. 2018;5:1104-8.

Cochrane Injuries Group Albumin Reviews. Human albumin administration in critically ill patients: systematic review of randomised controlled trials. BMJ. 1998;317:235-40.

Arikan AA, Citak A. Pediatric Shock, Signa Vitae. 2008;13-23.

Vasundhara A, Sahoo MR, Chowdary SS. Assessment of clinical parameters and immediate outcome of children with shock in a tertiary care hospital ASRAM, Eluru, Andhra Pradesh, India. International Journal of Contemporary Pediatrics. 2017;4:586-90.

Daljit Singh, Atul Chopra, Puneet Aulakh Pooni and R.C. Bhatia: A Clinical Profile of Shock in Children in Punjab, India. Indian pediatrics. 2006;43:619-623.

Ravikant M, H.K.G. Singh, Shrinivasreddy B. Clinical study of shock in children with special reference to prognostic determinant at teaching hospital, Bangalore. Medica Innovatica, 2015;4.

Fisher JD, Nelson DG, Beyersdorf H, Satkowiak LJ. Clinical Spectrum of Shock in the Pediatric Emergency Department. Pediatric Emergency Care. 2010;6.

Standl T, Annecke T, Cascorbi I, Heller AR, Sabashnikov A, Teske W. The nomenclature, definition and distinction of types of shock. Dtsch Arztebl Int. 2018;115:757–68.