A 76-year-old man is brought to the emergency department by ambulance after being found unconscious in his bathroom. His wife reports a 2-day history of fever, dysuria, and flank pain. His temperature is 36.0°C (96.8°F), pulse is 142/min and regular, respirations are 25/min, and blood pressure is 75/40 mm Hg. On physical examination, the patient appears lethargic, flushed, and diaphoretic. Neck veins are flat. The lungs are clear on auscultation and heart sounds are normal. There is right-sided costovertebral tenderness. Which of the following hemodynamic parameters are most likely to be present in this patient?

Question

A 76-year-old man is brought to the emergency department by ambulance after being found unconscious in his bathroom. His wife reports a 2-day history of fever, dysuria, and flank pain. His temperature is 36.0°C (96.8°F), pulse is 142/min and regular, respirations are 25/min, and blood pressure is 75/40 mm Hg. On physical examination, the patient appears lethargic, flushed, and diaphoretic.  Neck veins are flat.  The lungs are clear on auscultation and heart sounds are normal.  There is right-sided costovertebral tenderness.  Which of the following hemodynamic parameters are most likely to be present in this patient?

Quizplus · Accepted Answer

Eductional Objective: Septic shock causes widespread arteriolar vasodilation, which leads to a decrease in systemic vascular resistance and a compensatory increase in cardiac output.  Central venous pressure and pulmonary capillary wedge pressure are also decreased due to pooling of blood in the dilated veins.  Increased flow rates through the peripheral capillaries lead to incomplete oxygen extraction by the tissues and high mixed venous oxygen saturation.

A 76-Year-Old Man Is Brought to the Emergency Department by Ambulance