Hemodynamic monitoring in septic shock

Description

Septic shock usually induces a hyperdynamic state characterized by normal or high cardiac output, associated with a fall in peripheral resistances which is responsible for arterial hypotension; when the evolution is prolonged it usually leads to a low output syndrome with elevated peripheral resistances, suggesting the hemodynamic pattern of hypovolemic shock. All intermediate situations can be observed within these extremes. The hyperdynamic state corresponds to a decrease in aortic impedance, which is indirectly related to the effects of endotoxin on vascular bed. The low output syndrome is more usual at the advanced stage and corresponds to the intervention of associated factors such as progressive hypovolemia and/or myocardial dysfunction.