A 62-year-old male with a history of type 2 diabetes mellitus and hypertension was admitted with complaints of fever and productive cough for 4 days. He was tachypneic, respiratory rate 32/min, with SpO2 of 91% on 10 litres oxygen through non-rebreathing mask, which increased to 94% with high flow nasal oxygen (HFNO) at FiO2 80% and flow 60 l/min. His blood pressure was 100/56 mmHg, and his urine output was 0.3 ml/kg/h for the last 3 h. In view of respiratory distress with acute hypoxemic respiratory failure, he was intubated. Post-intubation, his BP dropped to 64/46 mmHg (MAP 56 mmHg). What would you do for resuscitation of this patient: IV fluids or vasopressors, or both?

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Fluid Stewardship

  • Prashant Nasa,
  • Manu Malbrain

摘要

A 62-year-old male with a history of type 2 diabetes mellitus and hypertension was admitted with complaints of fever and productive cough for 4 days. He was tachypneic, respiratory rate 32/min, with SpO2 of 91% on 10 litres oxygen through non-rebreathing mask, which increased to 94% with high flow nasal oxygen (HFNO) at FiO2 80% and flow 60 l/min. His blood pressure was 100/56 mmHg, and his urine output was 0.3 ml/kg/h for the last 3 h. In view of respiratory distress with acute hypoxemic respiratory failure, he was intubated. Post-intubation, his BP dropped to 64/46 mmHg (MAP 56 mmHg). What would you do for resuscitation of this patient: IV fluids or vasopressors, or both?