A 49 year male with a history of IV drug abuse presents with…
A 49 year male with a history of IV drug abuse presents with septic shock and receives 1.5L IVF in the ED. On arrival to your unit, his vital signs are the following: T 102.8F, HR 114, BP 77/52 (MAP 60), RR 24, O2 saturation 92% on 65% FiO2. An A-line and right IJ central line are placed by the ICU resident. A Flowtrac is attached to his A-line, and his hemodynamics are the following: CO 4.7, SV 97, SVR 638, and SVV 6. A bedside ultrasound shows his IVC is 35% collapsible. Based on this data, what is the appropriate intervention for his hypotension? Parameter Normal range Cardiac output 4-8L/min Stroke volume 60-130 ml/beat Systemic vascular resistance 770-1500 dynes/sec/cm-5 Stroke volume variation
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