Clinical criteria for the definition of refractory septic shock: a joint Delphi consensus from the Society of Critical Care Medicine (SCCM) and European Society of Intensive Care Medicine (ESICM) - Pu
4 hours ago
- #septic shock
- #Delphi consensus
- #critical care
- A joint Delphi consensus from SCCM and ESICM aimed to define clinical criteria for refractory septic shock.
- Refractory septic shock criteria include organ dysfunction markers, tissue perfusion indicators (lactate, capillary refill time), fluid responsiveness assessment, and vasoactive drug use (>0.5 µg/kg/min norepinephrine equivalents).
- Critical care ultrasound (CCUS) was the only diagnostic modality agreed upon for refractory septic shock assessment.
- Consensus was reached on 13 criteria out of 34 proposed statements after a five-round Delphi process involving 56 international experts.
- Refractory septic shock is characterized by persistent lactate elevation, prolonged capillary refill time, fluid unresponsiveness, high vasopressor requirements, and CCUS use in suspected mixed shock cases.