Clinical Resource Nurse at Sheikh Shakhbout Medical City/Nurse Clinical Educator for Adult Critical Care Units at American University of Beirut Medical Center
Time to reflect on managementof 33% of our ICU patients experiencing #shock or #circulatory #collapse ! A 55 yrs old 84 kg male patient arrives to ED with weakeness and confusion; admitted 4 weeks earlier c/o sepsis due to cellulitis. Patient transferred to #ICU for further management as recurrent #sepsis. In ICU BP 78/42, MAP 54, SpO2 82%. Intubated ventilated, lactate 9, CVP 8mmHg. Question: what is the best measure to optimize #tissue #perfusion? #Fluids vs. #vasoactive or #inotropic support? To navigate though your care always remember: Reliable early predictors of pressure status and perfusion response are imperative for caring for patients who are #hemodynamically #unstable. Although traditional static hemodynamic variables (CVP) are helpful, #advanced #variables of #hypotension #prediction allow safer more precise optimization of tissue perfusion. #Fluid #resuscitation without a step-wise process of measuring response is detrimental. Using #hemodynamic #optimization #algorithm can help personalize care and deliver accurate #EBP treatment plan.