A 65-year-old woman on ICU with septic shock has persistent hypotension (MAP 52 mmHg) despite noradrenaline 0.8 mcg/kg/min, vasopressin 0.03 units/min...

Question

A 65-year-old woman on ICU with septic shock has persistent hypotension (MAP 52 mmHg) despite noradrenaline 0.8 mcg/kg/min, vasopressin 0.03 units/min, hydrocortisone 200 mg/day, and adequate fluid resuscitation. Echo shows EF 65%. What additional resuscitation endpoint should be assessed?

Accepted Answer

Venous-to-arterial CO2 gap (Pv-aCO2 gap) - a Pv-aCO2 gap >6 mmHg (0.8 kPa) suggests inadequate tissue perfusion despite apparently normal global oxygen delivery, indicating that cardiac output may be insufficient relative to metabolic demands or that microcirculatory flow is inadequate

Answer

Only MAP matters

Answer

CRP level

Answer

Urine specific gravity

Answer

Serum albumin

uk-fficm MCQ (SBA): Pv-aCO2 Gap

A 65-year-old woman on ICU with septic shock has persistent hypotension (MAP 52 mmHg) despite noradrenaline 0.8 mcg/kg/min, vasopressin 0.03 units/min, hydrocortisone 200 mg/day, and adequate fluid resuscitation. Echo shows EF 65%. What additional resuscitation endpoint should be assessed?