instruction: refractory hypotension ( a systolic blood pressure < 90 mm hg despite an iv fluid challenge of at least 20 ml / kg over a 30 minute period ) or evidence of hypoperfusion ( a blood lactate concentration > / = 4 mmol / l )
response: SELECT * FROM table_train_61 WHERE (hypotension = 1 OR systolic_blood_pressure_sbp < 90) OR (hypoperfusion = 1 OR lactate >= 4)