Septic Shock PA Catheter Profile — FRCA Final MCQ

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ModerateIntensive Care MedicineSeptic Shock PA Catheter ProfileFRCA Final

A 60-year-old man in ICU has a pulmonary artery catheter. His measurements show: CO 8.5 L/min, SVR 450 dynes.s.cm⁻⁵, PCWP 8 mmHg, CVP 4 mmHg. He is febrile (39.2°C) and tachycardic (HR 115). These findings are most consistent with:

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Correct answer: A — Distributive (septic) shock

The PA catheter data shows: high cardiac output (8.5 L/min – hyperdynamic circulation), low SVR (450 – vasodilation), low-normal filling pressures (PCWP 8, CVP 4). This is the classic haemodynamic profile of warm/hyperdynamic septic shock (distributive shock). The high CO results from reduced afterload (low SVR), tachycardia, and potentially increased myocardial contractility from catecholamine release. Despite the high CO, tissue oxygen delivery may be inadequate due to maldistribution of blood flow (microcirculatory dysfunction). Treatment: antibiotics, source control, noradrenaline to improve SVR and MAP.

Reference: SSC – 2021 – Sepsis guidelines; RCOA – 2023 – ICM haemodynamic monitoring