Shock is typically associated with evidence of inadequate tissue perfusion on physical examination:

-Degree of cutaneous perfusion, decreased cap refill, mottling or extremities, blue lips, etc.
-Decreased urine output
-Altered mental status

The presence of low blood pressure should not be a prerequisite for defining shock: compensatory mechanisms may preserve blood pressure through vasoconstriction, while tissue perfusion and oxygenation are already decreased significantly.

The definition of circulatory shock emerging from this consensus conference does not require the presence of hypotension.

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