A 63-year-old with suspected sepsis has initial lactate 3.8 mmol/L. After 30 mL/kg crystalloid and antibiotics within the hour, MAP is 58 mm Hg. Next ...

Question

A 63-year-old with suspected sepsis has initial lactate 3.8 mmol/L. After 30 mL/kg crystalloid and antibiotics within the hour, MAP is 58 mm Hg. Next best step?

Accepted Answer

Start norepinephrine and target MAP ≥65 mm Hg

Answer

Add vasopressin as first vasopressor

Answer

Start phenylephrine as first vasopressor

Answer

Begin dopamine for renal perfusion

Answer

Give 1 L D5W and reassess in 6 hours

us-abem MCQ (SBA): Septic Shock-Vasopressors

A 63-year-old with suspected sepsis has initial lactate 3.8 mmol/L. After 30 mL/kg crystalloid and antibiotics within the hour, MAP is 58 mm Hg. Next best step?