My understanding in looking at the SSC (surviving sepsis campaign) website
is that it is hypotension refractory to IVF bolus and/or lactate greater
than or equal to 4.

However, the CMS publication reversed the two and wrote it as "lactate >=
to 4 and/or hypotension after IVF bolus."

So, grammarians in the group (like your intensivists) would say lactate
greater than 4 after fluid bolus.  However, my sentiment has been that it
is hypotension despite IVF bolus and/or lactate greater than 4 as that has
been the SSC guidelines for years.  I suspect some CMS minion was trying to
avoid plagiarism and changed the SSC statement slightly potentially
altering its interpretation.

Your thoughts?

Karin Molander MD
Mills-Peninsula Hospital
Sutter

On Thu, Oct 22, 2015 at 12:21 PM, <[email protected]>
wrote:

> Ok, listserve friends….there is an ongoing debate here.  Is Septic Shock
> defined as hypotension in spite of fluid resuscitation OR lactate greater
> than 4? Or is septic shock defined as hypotension in spite of fluid
> resuscitation or lactate greater than 4 *after* fluid resuscitation?
>
>
>
> Our intensivists are saying septic shock is only septic shock if they are
> on vasopressors or the patient’s lactic acid remains greater than 4 after
> fluid resuscitation.
>
>
>
> Thank you,
>
> Debbie
>
>
>
> Debbie Chambless, MSN, RN, ARNP-C
>
> Sepsis Coordinator
>
> Osceola Regional Medical Center
>
> Kissimmee, Fl 34741
>
> Office: 407-518-3949
>
> Cell: 772-807-0525
>
>
>
> *~~Recognizing sepsis as a global enemy.  Hoping for global unity in
> finding a solution~~*
>
>
>
>
>
> _______________________________________________
> Sepsisgroups mailing list
> [email protected]
> http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.org
>
>


-- 
Karin H. Molander
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