ReviewSage open pediatrics
Refractory Shock in Pediatric Emergency Departments: Challenges and Innovations in Early Escalation: A Narrative Review.
Review in Sage open pediatrics. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Refractory shock in children carries persistently high mortality, particularly in low-resource settings. It occurs when circulatory failure persists despite adequate fluid resuscitation and vasoactive medications. This review summarizes pathophysiology, recognition, and escalation strategies for pediatric refractory shock, emphasizing early identification in the emergency department. It examines evidence for fluid management, vasoactive therapy, and point-of-care ultrasound in optimizing decision-making, along with second-line options such as corticosteroids, vasopressin, and milrinone. Special attention is given to resource-constrained settings, describing evidence-based adaptations including conservative fluid strategies from the FEAST trial, simplified algorithms, simulation-based training, and telemedicine. Improving outcomes requires rapid recognition, precise hemodynamic phenotyping, and timely evidence-based interventions.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.