Burn-induced myocardial depression in a pediatric patient leading to fulminant cardiogenic shock and multiorgan failure requiring extracorporeal life support.

Cardiac stress is a critical determinant of outcomes associated with severe thermal injury. The cardiovascular response to a catecholamine-mediated surge from severe burns passes through two phases. Initial hypovolemia with myocardial depression leads to a low cardiac output, which then progresses to a hyperdynamic-hypermetabolic phase with increased cardiac output.