In septic shock, what is a typical initial hemodynamic change?

In septic shock, what is a typical initial hemodynamic change?

• A. Massive vasodilation reducing afterload and SVR; CO may initially increase
• B. Increased preload
• C. Increased afterload
• D. No change in SVR

Answer: (A)

In septic shock, the body's inflammatory response causes widespread vasodilation, so systemic vascular resistance falls and afterload is reduced. With less resistance to eject blood against, the heart can maintain or even increase its output early on, aided by sympathetic stimulation and a higher heart rate. That combination—low SVR and low afterload with potentially elevated cardiac output—is the classic initial hemodynamic pattern. Preload can vary and may be affected by fluid status, but the defining early change is the marked vasodilation with decreased afterload and SVR, sometimes accompanied by a high cardiac output. Over time, ongoing capillary leak and myocardial depression can alter these dynamics.

In septic shock, the body's inflammatory response causes widespread vasodilation, so systemic vascular resistance falls and afterload is reduced. With less resistance to eject blood against, the heart can maintain or even increase its output early on, aided by sympathetic stimulation and a higher heart rate. That combination—low SVR and low afterload with potentially elevated cardiac output—is the classic initial hemodynamic pattern. Preload can vary and may be affected by fluid status, but the defining early change is the marked vasodilation with decreased afterload and SVR, sometimes accompanied by a high cardiac output. Over time, ongoing capillary leak and myocardial depression can alter these dynamics.