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Comment & Response |

Defining Septic Shock—Reply

Manu Shankar-Hari, MD, MSc1; Mervyn Singer, MD, FRCP2
[+] Author Affiliations
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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In Reply Sepsis-3 defines septic shock as a life-threatening, generalized form of acute circulatory dysfunction (represented as vasopressor-dependent hypotension) associated with inadequate oxygen utilization (represented as hyperlactatemia), but with the important caveat of adequate fluid resuscitation. This definition has strong similarities to the consensus recommendations1 cited by Dr Hernández and colleagues. This change in clinical criteria describing this definition will alter the epidemiology of septic shock because of reclassification2 but should offer greater consistency, as the current incidence varies 10-fold and mortality 4-fold.

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July 26, 2016
Glenn Hernández, MD, PhD; Flávia Machado, MD; Gustavo Ospina-Tascón, MD, PhD
1Departamento de Mecicina Intensiva, Pontificia Universidad Católica de Chile, Santiago
2Discipline of Anesthesiology, Pain, and Intensive Care, Federal University of São Paulo, São Paulo, Brazil
3Intensive Care Medicine Department, Fundación Valle del Lili-Universidad ICESI, Cali, Colombia
JAMA. 2016;316(4):454-455. doi:10.1001/jama.2016.6137.
July 26, 2016
Anja Kathrin Jaehne, MD; Namita Jayaprakash, MD, MB BCh BAO, MRCEM; Sam Langberg, MD
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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