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