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.
Shankar-Hari M, Singer M. Defining Septic Shock—Reply. JAMA. 2016;316(4):456. doi:10.1001/jama.2016.6145