A 72-year-old man on ICU with septic shock has received aggressive fluid resuscitation (50 mL/kg) over 6 hours. His CVP is 14 mmHg, MAP is 62 mmHg on ...

Question

A 72-year-old man on ICU with septic shock has received aggressive fluid resuscitation (50 mL/kg) over 6 hours. His CVP is 14 mmHg, MAP is 62 mmHg on noradrenaline 0.15 mcg/kg/min, and ScvO2 is 68%. A passive leg raise test shows no increase in cardiac output. What does the PLR result indicate about further fluid management?

Accepted Answer

The patient is unlikely to benefit from further fluid administration - additional fluid may cause harm (pulmonary oedema, third-spacing, organ oedema)

Answer

The patient needs more fluid - give another 30 mL/kg

Answer

The PLR is unreliable in septic shock

Answer

The CVP of 14 confirms adequate filling - no further assessment needed

Answer

The PLR must be repeated 3 times before interpretation

uk-fficm MCQ (SBA): Fluid Responsiveness - PLR