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Comment & Response
July 26, 2016

Defining Septic Shock

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

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).