Which hemodynamic profile is typical of septic shock?

• A. High cardiac output with low PCWP and low systemic vascular resistance
• B. Low cardiac output with high PCWP
• C. High systemic vascular resistance with high PCWP
• D. Normal hemodynamics

Answer: (A)

Septic shock causes a distributive pattern where widespread vasodilation lowers systemic vascular resistance, and the heart often pumps more vigorously to compensate, giving a high cardiac output. At the same time, fluid shifts out of the intravascular space due to capillary leak and vasodilation, so the circulating volume is relatively reduced and filling pressures fall. Pulmonary capillary wedge pressure reflects left atrial preload, so it tends to be low in this scenario. Putting it together, the typical profile is high cardiac output with low preload (low PCWP) and low systemic vascular resistance.

Other hemodynamic patterns describe different shock states—for example, low output with high filling pressures fits cardiogenic or hypovolemic conditions, while high systemic vascular resistance is not characteristic of early septic shock. Normal hemodynamics wouldn’t reflect the vasodilation and cardiac compensation seen in sepsis.