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What is your approach to volume resuscitation in patients with obvious septic shock but also with a component of suspected cardiogenic shock?

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What modalities do you use to aid in your assessment of volume status in the management of patients with shock?

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4 Answers
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Pulmonology · University of Florida Health - Jacksonville
Answered on

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...

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Pulmonology · M Health Fairview Specialty Care Clinic Edina
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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...

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Pulmonology · Uchicago Medicine Ingalls Memorial Hospital
Answered on

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.

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Pulmonology · Sutter Medical Center Sacramento
Answered on

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

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