Shock and the Collapsed Baby

Shock and the collapsed baby

Shock results from inadequate oxygen delivery to meet metabolic demands of the tissues. When CHD presents as shock, it is often due to symptomatic obstruction of the left ventricular outflow tract. Adequate blood flow depends on a patent ductus arteriosus therefore when this closes after birth, systemic blood flow decreases.

Causes of Neonatal shock/collapse

Learning Bite

The five main causes of circulatory collapse in the neonate are:

  1. Sepsis
  2. CHD
  3. Metabolic/Endocrine disturbances (including inborn errors of metabolism)
  4. NAI
  5. Trauma

Another useful way to remember common causes of neonatal collapse is the mnemonic “THE MISFITS”.

T Trauma
H Heart disease
E Endocrine
M Metabolic/electrolyte disturbance
I Inborn errors of metabolism
S Seizures/CNS abnormalities
F Formula errors e.g over-dilution
I Intestinal disorders e.g Intussusception
T Toxins
S Sepsis

Presentations of Shock   

How is the presentation of shock different in neonates compared to adults?


table for congenital heart

Learning bite

Apnoea is a common side effect of Prostaglandin infusions – ensure senior help is available when considering an infusion. It is important to know where Dinoprostone is kept in your department. It may also be useful to run/attend simulation scenarios around shock in the neonate.