Question

A 62-year-old man presents with fever, confusion, and hypotension after a urinary source is suspected. After broad-spectrum antibiotics and 30 mL/kg IV crystalloid, his MAP remains 58 mm Hg and lactate is 5.2 mmol/L. What is the next best step to achieve the initial hemodynamic target?

Accepted Answer

Start norepinephrine infusion to target MAP ≥65 mm Hg

Answer

Start dopamine infusion

Answer

Give IV hydrocortisone 200 mg/day immediately

Answer

Administer 25% albumin bolus

Answer

Delay further therapy until a central line is placed

Practice question

A 62-year-old man presents with fever, confusion, and hypotension after a urinary source is suspected. After broad-spectrum antibiotics and 30 mL/kg IV crystalloid, his MAP remains 58 mm Hg and lactate is 5.2 mmol/L. What is the next best step to achieve the initial hemodynamic target?