Cold septic shock: recognising the low‐output phenotype
Year: 2026
Type: article
Abstract: Septic shock is commonly taught as a warm, vasodilated state, but the cold, low‐output phenotype, in which the underlying process is still sepsis but cardiac output is low and vascular resistance high, is under‐recognised. Escalating vasopressors alone in these patients support the blood pressure while leaving the low output untreated. I describe how I separate low from high cardiac output shock at the bedside using peripheries, pulse pressure and central venous oxygen saturation and where cold septic shock and its mechanisms sit within this framework. The phenotype is recognised at the bedside, whereas identifying the underlying mechanism usually requires echocardiography. The central principle is to treat the haemodynamic phenotype, not the label.
Source: Internal Medicine Journal
DOI: 10.1111/imj.70701
Author: Prashant Maan
Institution: The University of Queensland
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $3,570
OpenAlex ID: W7225621429