Distributive shock with adequate preload indicated by SVV of 10%, high SV and cardiac output, and low SVR. On levophed, epinephrine, and vasopressin. Lactic acid 13.
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Hemodynamics Management
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Distributive shock with adequate preload indicated by SVV of 10%, high SV and cardiac output, and low SVR. On levophed, epinephrine, and vasopressin. Lactic acid 13.
A case of distributive shock, preload is adequate as shown CVP 14 , SVV is 10 % , SV , CO and CI are high , Very low SVR 411. On triple vasopressors but lactate is very high 13.
Clinical history in details is important.
I will optimise the vasopressors especially noradrenaline infusion according to SVR and UOP. I will recommend to add a small dose of dobutamine to improve tissue perfusion which will help in lowering down the lactate levels and will check lactate levels frequently to know the right path of resuscitation and management. I will do SCvO2 level and HB value . As per protocol I will treat the underlying cause as soon as possible. In case of septic shock, initiation of adequate and appropriate antibiotics will be given accordingly.
I will do liver function test , as in liver dysfunction the lactase level remains high.
I will check renal function test and close eyes ๐ on UOP.