shock

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Related to refractory shock: refractory septic shock
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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.
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.