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December 23, 1983

Septic Shock: Hemodynamics and Pathogenesis

Author Affiliations

From the Critical Care Medicine Department, Clinical Center, National Institutes of Health, Bethesda, Md.

JAMA. 1983;250(24):3324-3327. doi:10.1001/jama.1983.03340240050031

PATIENTS suffering from shock secondary to sepsis are common in the practice of a wide variety of specialties—surgery, internal medicine, obstetrics, and pediatrics. Septic shock is frequently a serious complication of otherwise successful surgical or medical intervention, and, therefore, the hemodynamic patterns of this form of shock should be familiar to all physicians potentially caring for acutely ill patients.

Although the precise incidence of sepsis and septic shock is difficult to document, recent estimates of gram-negative rod bacteremia in the United States range from 70,000 to 300,000 cases each year.1,2 Shock complicates approximately 40% of these cases and has a mortality ranging from 40% to 90%. Therefore, gram-negative rod bacteremic shock results in approximately 20,000 to 60,000 deaths each year. The mortality statistics for all sepsis (including gram-positive and gram-negative organisms, fungi, and viruses) would be substantively higher. Therefore, shock secondary to sepsis is a serious common disease with