Beyond Lactate: Real-Time Resuscitation Targets for Septic Shock During Critical Care Transport

Septic shock remains one of the most physiologically complex and time-sensitive conditions encountered by critical care transport teams. Despite decades of protocolized resuscitation strategies, mortality remains high, and clinicians continue to debate the optimal targets to guide ongoing resuscitation once initial stabilization has begun. Measurement of serum lactate has served as the dominant biomarker for shock severity and response to therapy, driving fluid administration, vasoactive support, and escalation of care across emergency departments, intensive care units (ICUs), and transport environments.