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Defining Septic Shock

Anja Kathrin Jaehne, MD1; Namita Jayaprakash, MD, MB BCh BAO, MRCEM2; Sam Langberg, MD1
[+] Author Affiliations
1Department of Emergency Medicine, Henry Ford Hospital, Detroit, Michigan
2Department of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, Minnesota
JAMA. 2016;316(4):455. doi:10.1001/jama.2016.6140.
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To the Editor A panel of 19 experts conducted an extensive and complex analysis of current literature and sepsis databases to develop new SEPSIS-3 definitions and clinical criteria for sepsis and septic shock.1 Despite this effort, some concerns remain in regard to these definitions.

The new definition of septic shock states that “Adult patients with septic shock can be identified using the clinical criteria of hypotension requiring vasopressor therapy to maintain mean [blood pressure] of 65 mm Hg or greater and having a serum lactate level greater than 2 mmol/L after adequate fluid resuscitation.”1 This definition excludes a number of patients with septic shock who are alactatemic (lactate level <2 mmol/L).


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July 26, 2016
Manu Shankar-Hari, MD, MSc; Mervyn Singer, MD, FRCP
1Department of Critical Care Medicine, Guy’s and St Thomas’ NHS Foundation Trust, London, United Kingdom
2Bloomsbury Institute of Intensive Care Medicine, University College London, London, United Kingdom
JAMA. 2016;316(4):456. doi:10.1001/jama.2016.6145.
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