Which type of shock is characterized by decreased CO and decreased PCWP?

Septic shock is characterized by decreased cardiac output (CO) and decreased pulmonary capillary wedge pressure (PCWP). In the setting of septic shock, widespread vasodilation occurs due to the release of inflammatory mediators, leading to a reduction in systemic vascular resistance. This vasodilation can cause an initial elevation in heart rate to compensate for the drop in systemic vascular resistance, but as the condition progresses, cardiac output may decrease.

The PCWP, which reflects left atrial pressure, is often low in septic shock because it is typically associated with peripheral vasodilation and relative hypovolemia rather than true volume overload, leading to reduced filling pressures in the heart. Therefore, both decreased CO and decreased PCWP are indicative of the impaired hemodynamics caused by septic shock, differentiating it from other types of shock.

In contrast, hypovolemic shock would present with decreased CO but typically shows a compensatory increase in PCWP due to volume depletion. Cardiogenic shock is characterized by low CO with elevated PCWP as the fluid backs up into the pulmonary circulation due to heart failure. Anaphylactic shock, like septic shock, can lead to decreased systemic vascular resistance, but this usually does not lead to decreased CO or decreased PCWP