Sunday, February 17, 2019

Challenges in the management of septic shock: a narrative review

Why I really like this article 

It may not be a bad idea to keep this sentence on a sticky note for intervention answers, if you have to deal with the same endless questions in regards to therapy:
1.  Urine output is a good marker of shock at a very early onset but not a good marker for resuscitation.  Is neither sensitive nor specific for improvement in renal perfusion.
Use this for the same intervention question: Oliguria, only 15 mL this shift… Suggestions?
2.  Another good one is also: Lactate is going up… You want me to give a fluid bolus?
Answer:" I am awaiting randomized trials" [should with target lactate reduction, and to which magnitude, or lactate normalization AND your headache will also be better.


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