What is your approach to volume resuscitation in patients with obvious septic shock but also with a component of suspected cardiogenic shock?
Answer from: at Community Practice
I think it comes down to clinical decision-making at bedside with the help of a combination of modalities. POCUS to evaluate the IVC size and collapsibility is one option we commonly use and is quick and easy to obtain. Additionally, in situations of unclear shock state, our practice is to float a P...
I find one needs to use multiple modalities to make accurate volume assessments - history, exam, POCUS, bedside maneuver, pulse pressure variation, etc. Typically, if multiple assessments point in one direction (volume down or volume up, IVC collapsible, wide pulse pressure variation, pt down from d...
I use POCUS and I perform limited critical care echocardiogram to measure LVOT VTI, LVOT diameter, and RV systolic function- TAPSE, LV diastolic function and TR velocity for RVSP, rule out pericardial effusion and IVC diameter and variation with respiration.
We’ve used Cheetah for years in the West Coast. It minimizes unnecessary fluid administration. Proprietary formula but seems to guide decision to start pressors. Cannot tell if you have carcinogenic shock but POCUS might help