March 2025
In the setting of septic shock, or evolving septic shock, cardiovascular status is of paramount importance. Severe shock is present if there is hypotension, tachycardia, very prolonged capillary refill time and cold limbs. Such children require fluid resuscitation with early repeated boluses of 10-20mL/kg of normal saline or a balanced salt solution. If shock persists despite 40mL/kg in total, a differentiated approach to shock is needed, and the addition of vasopressor or inotropic agents, is required. Many children respond to oxygen, fluid, and low dose vasopressors.
Refer to the Royal Children’s Hospital Clinical Practice Guideline: