Etiological Profiles and Therapeutic Challenges of Pediatric Shock in Senegal

Abstract

Introduction: Shock is a failure of the circulatory system, resulting in an imbalance between oxygen supply and tissue demand. The objective of this study was to evaluate the etiological profiles and therapeutic challenges of shock in children. Patients and methods: This was a prospective, descriptive, observational, and analytical study conducted from October 10, 2022, to October 23, 2023 (12 months), including all children hospitalized for shock in the emergency and pediatric intensive care units at the Albert Royer National Children's Hospital (CHNEAR). Results: During this period, 146 patients presented with shock, representing a hospital prevalence of 11.33%. The mean age was 43.12 months. The sex ratio was 0.82. Signs of tissue hypoperfusion were present in almost all patients. Arterial hypotension was found in 45.52% of cases. Septic shock was predominant (55.00%), followed by hypovolemic shock (31.43%) and cardiogenic shock (10%). The outcome was unfavorable in most cases, with 69.18% of deaths due mainly to septic shock (47.29%), the main causes of death being refractory shock (48.51%), renal failure (32.19%), and disseminated intravascular coagulation (15.07%). Conclusion: Shock is a diagnostic and therapeutic emergency in which the delay in treatment and the duration of shock are important factors in the prognosis.