Mixed shock
Educational use only. Not clinically reviewed66-year-old woman for Mixed-shock reassessment. About 9 simulated minutes.
What you will practise
- Recognize worsening shock with discordant cardiac and vasodilatory clues and activate experienced help.
- Integrate output, filling pressure, vascular tone, echo, lungs, and perfusion without forcing one shock label.
- Record concurrent tone and output support review while avoiding blind fluid loading.
- Keep cardiac and infectious cause-control pathways active in parallel.
- Reassess perfusion, hemodynamics, congestion, infection, gas exchange, and organ trajectory.
Review and sources
Not clinically reviewed. No clinician has signed this scenario.
- van Diepen S, Pöss J, Senaratne JM, Gage A, Morrow DA. Mixed Cardiogenic Shock: A Proposal for Standardized Classification, a Hemodynamic Definition, and Framework for Management. Circulation. 2024;150:1459-1468.
- Sinha SS, Morrow DA, Kapur NK, Kataria R, Roswell RO. 2025 Concise Clinical Guidance: An ACC Expert Consensus Statement on the Evaluation and Management of Cardiogenic Shock. J Am Coll Cardiol. 2025;85:1618-1641.
- Monnet X, Messina A, Greco M, et al. ESICM guidelines on circulatory shock and hemodynamic monitoring 2025. Intensive Care Med. 2025;51:1971-2012.
- Prescott HC, Antonelli M, Alhazzani W, et al. Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2026. Crit Care Med. 2026;54:725-812.
Open Sim Lab is an educational simulator, not for clinical use. It is not a clinical decision-support tool, not a dosing calculator, and is not validated for any decision affecting a real patient.