(^)
Infant stable
Infant Unstable (^)
(^)
(^)
- (^) Fluid resistant
Shock
(^)
(^)
(^) resistaCatecholaminent
shock
(^) Persistent Shock
(^)
Refractory (^)
Shock^
Continue antibiotics and supportive care. If cultures are negative and suspicion of
sepsis is low, discontinue antibiotics within 48 hours.
Provide further hemodynamic and respiratory Escalate support^
support, including positive pressure ventilation
congenital heartConsider undiagnosed disease
Continue diagnostic work-up and source
control
Continue fwith isotonic crystluid resuscitationalloid or
colloid; up to hemodynamics improve. 60 - 80 ml/kg until
Continue and direct antibiotics toward most
suspected source. Proceed with operative
intervention, if indicated.
Start inotropic support (^) prostaglandECHO ins, and start if indicated
Dopamiand/or Epinephrinene 10 - 15 mcg/kg/min 0.05-0.3 mcg/kg/min
Titrate to goal MAP based on age.
Hydrocortisone 1.5 mg/kg q 6 hoursAdd stress dose steroids^ x 8,
then maintenance. 0.5 mg/kg q 6 hours as
Assure source controlobstructive shock (abdominal and rule out compartment
syndrometamponade,pneumothorax), pericardial effusion with
ECMO
- (^) Fluid resistant