<prompt> All are true about septic shock in children except1st response is C.O. due to vasodilatationHypotension is a late signHeart rate remains samePeripheral vascular resistance  <response>: Septic shock in childrenSeptic shock is an inflammatory state resulting from a systemic response to bacterial infection.The decrease in peripheral resistance vasodilatation is the hallmark of early hyper dynamic stage of septic shock, this feature distinguishes it from other types of shock. Decreased peripheral resistance vasodilatation leads to a compensatory increase in cardiac output; therefore, cardiac output is maintained or some time increased despite of shock.Decreased peripheral resistance and increased cardiac output lead to increased blood flow and total oxygen delivery to the tissue. But, still, the tissues lack O2 due to local microcirculatory changes produced as a result of sepsis which causes decrease tissue extraction of oxygen. So, increased blood flow and cardiac out are still inadequate to meet the total metabolic needs of the tissue which are increased in sepsis.As sepsis progresses, hypo dynamic stage supervenes in which there is decreased cardiac output and increased peripheral resistance.So, hemodynamic changes in septic shock occur in two characteristic patterns, Early hyperdynamic and late hypo dynamic shock1 Early hyperdynamic shockHypotension is a late feature of septic shock and early hyperdynamic stage is characterized by normal or increased BROther features are : -Tachycardia Normal or increased cardiac output Tachypnea Warm extremities Decreased systemic vascular resistance Increased pulmonary vascular resistance 2 Late hypo dynamic stageDecreased cardiac output Hypotension Increased vascular resistance Cool, mottled and often cyanotic extremities Oliguria, renal failure Hypothermia 