In which type of shock might you see hypotension that responds poorly to fluid resuscitation?

In septic or distributive shock, hypotension often occurs due to vasodilation resulting from the release of inflammatory mediators, which can lead to impaired tissue perfusion. While fluid resuscitation is a cornerstone of treatment for various types of shock, the underlying cause in septic shock means that simply increasing the volume of fluids can be insufficient to restore blood pressure effectively. This situation arises because the vessel walls are already dilated, making it difficult for fluid resuscitation alone to raise blood pressure to satisfactory levels.

In contrast, hypovolemic shock typically sees a more direct response to fluid resuscitation since it is primarily caused by a significant loss of blood or fluids. Cardiogenic shock results from heart failure, where fluid administration can help to increase preload but may not address the fundamental issue of heart function. Obstructive shock involves physical obstructions in circulation, and while fluids may help, they are not as impactful if the obstruction is not resolved. Thus, septic or distributive shock uniquely presents with a poor response to fluid resuscitation due to the nature of vasodilation and the effects of septic shock on the vascular system.