Indian journal of pediatrics
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The neonate with circulatory failure and cardiogenic shock is a difficult management problem. However, the initial approach is that of resuscitation with exact diagnosis of secondary concern. Once the infant has been stabilized and septic and hypovolemic shock have been excluded, attention should be directed to the four most likely causes of cardiogenic shock: structural heart disease with left heart obstruction being the most common, cardiac muscle disorders, cardiac dysrhythmias, and cardiac metabolic disorders.
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Septic shock is the host's inflammatory response to infection. There are multiple endogenous mediators responsible for the pathogenesis of septic shock. Cytokines, nitric oxide and prostaglandins are some of the major mediators. ⋯ Management of septic shock is focused in maintaining hemodynamic stability and an adequate oxygen delivery and utilization. Careful attention to each organ-system is of paramount importance to prevent complications and improve outcome. Experimental therapies to modulate the inflammatory response are promising.