refractory shock


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Related to refractory shock: refractory septic shock

refractory shock

Shock that does not respond to standard treatments, e.g., with oxygenation and ventilation, fluid resuscitation and the restoration of perfusion, and identification and treatment of infection. It typically requires high doses of vasopressors, e.g., more than 15 mcg/kg/min of dopamine to maintain a blood pressure of 60 mm Hg.
See also: shock
References in periodicals archive ?
Children with shock responded to inotropic support of dobutamine up to 10-15 mcg/kg/min infusion except 2 cases which did not improve and died within 4 hours of admission due to acute pulmonary edema and catecholamine refractory shock. Significant echocardiographic findings were encountered in 42 children of our study group and their hospital stays are shown in Table 4.
Because of refractory shock not responding to high-dose noradrenaline, intravenous vasopressin was added (2 IU/hour), after which the noradrenaline infusion rate could be tapered.
Three patients died (4.9% mortality); 2 from complications related to aspiration pneumonia and 1 from refractory shock secondary to concomitant beta-blocker overdose.
Refractory shock was present in 16 (12.5%) and progressive renal failure occurred in 15 (12%).