A 51-year-old man with suspected sepsis receives antibiotics and 30 mL/kg fluids. Lactate recheck at 3 hours is 3.0 mmol/L (down from 5.0). BP 92/58 d...

Question

A 51-year-old man with suspected sepsis receives antibiotics and 30 mL/kg fluids. Lactate recheck at 3 hours is 3.0 mmol/L (down from 5.0). BP 92/58 despite norepinephrine 0.1 mcg/kg/min. Next step?

Accepted Answer

Add vasopressin to raise MAP and reduce norepinephrine dose

Answer

Switch to dopamine

Answer

Start dobutamine in all cases

Answer

Give corticosteroids before any vasopressor adjustment

Answer

Stop norepinephrine

us-abem MCQ (SBA): Septic Shock-Adjunct Vasopressin

A 51-year-old man with suspected sepsis receives antibiotics and 30 mL/kg fluids. Lactate recheck at 3 hours is 3.0 mmol/L (down from 5.0). BP 92/58 despite norepinephrine 0.1 mcg/kg/min. Next step?