**1. Introduction**

Sepsis is defined as life-threatening condition caused by a dysregulated host response to infection, resulting in organ dysfunction while septic shock is circulatory, cellular, and metabolic abnormalities in septic patients, presenting as fluid-refractory hypotension requiring vasopressor therapy with associated tissue hypoperfusion [1]. Septic shock has high mortality rate and constitutes 20% of all global deaths [2]. Mortality associated with septic shock range from 24–41% [3–6]. Increased morbidities and decreased functional status of septic shock patients after hospital discharge are major concerns and related to poor management [7]. Management of Septic shock include early recognition, source control with antibiotic and surgical intervention if needed, adequate perfusion and vital organ support including renal and respiratory support [8]. Patient in the early stage of septic shock required individualized fluid resuscitation and early administration of vasopressor to ensure tissue perfusion.

## **2. Indices of Hypoperfusion**

Progression of sepsis to septic shock occur very quickly and leads to hypoperfusion, end organ failure and death. **Figure 1** summaries the pathophysiology of sepsis and septic shock [9–11]. Hemodynamic, clinical and laboratory indices could be used to determine the level of hypoperfusion and its response to resuscitation. **Table 1** summaries the perfusion indices of and their targets during resuscitation.

#### **Figure 1.**

*Pathophysiology of sepsis and septic shock.*


#### **Table 1.**

*Indices of hypoperfusion and their targets.*
