A 76-year-old with pneumonia is on norepinephrine for septic shock after adequate fluids; MAP goal 65 mm Hg achieved. Lactate remains 4.5 mmol/L. What...

Question

A 76-year-old with pneumonia is on norepinephrine for septic shock after adequate fluids; MAP goal 65 mm Hg achieved. Lactate remains 4.5 mmol/L. What additional action is recommended?

Accepted Answer

Increase MAP goal to 75-85 mm Hg universally

Answer

Give vasopressin as first-line to replace norepinephrine

Answer

Assess and optimize perfusion (e.g. repeat lactate, capillary refill) and source control; avoid indiscriminate MAP escalation

Answer

Repeat lactate

Answer

Capillary refill

and source control. routine higher map targets or universal steroids are not recommended (a MCQ (SBA): Septic

A 76-year-old with pneumonia is on norepinephrine for septic shock after adequate fluids; MAP goal 65 mm Hg achieved. Lactate remains 4.5 mmol/L. What additional action is recommended?