In septic shock, what is the typical status of the pulmonary capillary wedge pressure (PCWP)?

• A. Normal
• B. Decreased
• C. Increased
• D. Highly variable

Answer: (A)

In septic shock the circulation is distributive rather than due to left-heart failure. The left atrial pressure, reflected by the pulmonary capillary wedge pressure, tends to stay normal because preload of the left ventricle is not elevated by cardiac dysfunction. The hallmark is high cardiac output with vasodilatory pooling, so PCWP remains within the normal range. An increased PCWP would point toward cardiogenic edema or left-sided failure, not typical septic shock. It can be lower if there is true hypovolemia, but the usual scenario is a normal PCWP.