VASCULAR AND MULTIORGAN DYSFUNCTION
Among the most prominent clinical and hemodynamic features of septic shock are low systemic vascular resistance and decreased peripheral use of oxygen and other nutrients. The decreased arteriovenous oxygen difference suggests that oxygen is not reaching or being used by cells1,17. The exact nature of this abnormality is poorly understood. One possibility is that vascular abnormalities (see below) result in decreased tissue perfusion, similar to the decreased perfusion caused by severely decreased cardiac output in patients with cardiogenic or hypovolemic shock. Another is that tissue perfusion is adequate but cellular metabolism is reduced.