how to diagnose shock in the ICU


  • can have shock without hypotension
  • look for clinical and lab signs of tissue hypoperfusion instead
    • brain: AMS
    • kidney: oliguria
    • skin: mottled
    • lab: lactate1
  • both tachycardia and bradycardia can point to shock
  • oliguria: low urine output is less than 0.5 cc per kg
  • mottling of skin suggests active vasoconstriction and could have benefit from inotrope not more vasoconstrictors

Footnotes

  1. CHEST Board Review Critical Care?