Shock type | Diagnostic criteria |
---|---|
Shock overall | Diagnosis of shock is confirmed if sustained shocka can be confirmed by medical chart review by at least one of the following [1,15]:b |
1. Systolic blood pressure < 90 mmHg. | |
2. Mean arterial pressure < 70 mmHg. | |
3. Reduction in systolic blood pressure > 40 mmHg. | |
4. Preserved systolic blood pressure achieved through inotropic/vasopressor therapy. | |
Cardiogenic shock | Diagnosis of cardiogenic shock is confirmed if medical chart review confirms these two criteria [4,16]: |
1. Sustained shock (as defined in shock overall) [1,15], and | |
2. Two or more of the following criteria were confirmed: | |
a. Cardiac index < 2.2 (L/min)/m2, | |
b. pulmonary capillary wedge pressure > 18 mmHg, | |
c. tachycardia (>90 beats per minute), | |
d. pale, cold, clammy, or cyanotic skin, | |
e. signs of oliguria, or | |
f. confusion, disorientation, or loss of conscience. | |
Hypovolemic shock | Diagnosis of hypovolemic shock is confirmed if medical chart review confirms these two criteria: |
2. Evidence or suspicion of shock due to (one or more of the following) [4]: | |
a. Loss of red blood cell mass and plasma from hemorrhage. | |
b. Loss of plasma volume alone due to extravascular fluid sequestration. | |
c. Gastrointestinal, urinary, and insensible losses. | |
Septic shock | Diagnosis of septic shock is confirmed if medical chart review confirms these three criteria [1,15,17]: |
2. Systemic inflammatory response syndrome (SIRS) must be diagnosed by identifying at least two or more of the following: | |
a. Tachypnea: high respiratory rate) > 20 breaths per minute, or arterial blood gas, with PCO2 less than 4.3 kPa signifying hyperventilation. | |
b. White blood cell count either significantly low < 4000 cells/mm3, elevated > 12000 cells/mm3, or >10 immature cells. | |
c. Heart rate > 90 beats per minute. | |
d. Temperature: Fever > 38.3°C (100.4°F) or hypothermia < 36.0°C (96.8°F). | |
3. Sepsis and not an alternative form cause of SIRS. Sepsis requires evidence or suspicion of infection, which may include: | |
a. Positive blood culture/blood culture taken as suspicious of infection, | |
b. signs of pneumonia on chest x-ray, or | |
c. other radiologic or laboratory evidence of infection. |