A 60-year-old man with septic shock is receiving noradrenaline at 0.6 mcg/kg/min and vasopressin at 0.03 units/min. MAP is 60 mmHg. Echocardiography s...

Question

A 60-year-old man with septic shock is receiving noradrenaline at 0.6 mcg/kg/min and vasopressin at 0.03 units/min. MAP is 60 mmHg. Echocardiography shows severely impaired LV systolic function with an EF of 20%, consistent with septic cardiomyopathy. Lactate is 6.8 mmol/L, ScvO2 55%. What is the most appropriate next step?

Accepted Answer

Add dobutamine at 5 mcg/kg/min and titrate to response

Answer

Increase noradrenaline to 1.0 mcg/kg/min

Answer

Commence adrenaline infusion at 0.1 mcg/kg/min

Answer

Commence milrinone at 0.375 mcg/kg/min

Answer

Commence levosimendan 0.1 mcg/kg/min

uk-fficm MCQ (SBA): Septic Cardiomyopathy