ABSTRACT
Methods for monitoring resuscitation of patients in overt shock, as well as those with less obvious occult hypoperfused states, continues to be actively pursued. Along with research into shock states, increased standardization in definitions has been required. To this end, the American College of Surgeons Committee on Trauma (ACS-COT) defined shock as “an abnormality of the circulatory system that results in inadequate organ perfusion and tissue oxygenation” (1). The American College of Chest Physicians (ACCP) and the Society of Critical Care Medicine (SCCM) similarly established a Consensus Conference Committee, which defined shock associated with sepsis as “. . . hypotension [systolic blood pressure (SBP) ,90 mmHg or reduction 40 mmHg from baseline] despite adequate fluid resuscitation, along with the perfusion abnormalities that may include, but are not limited to: (i) lactic acidosis, (ii) oliguria, or (iii) an acute alteration in mental status” (2).
