emDocs - April 19, 2016 - Author: Long A - Edited by: Koyfman A & Long B
Conclusions
- Vital signs are vital! Drops in blood pressure lead to increased mortality, and blood pressure may not respond simply to fluids.
- Vasopressors should be started early in septic shock patients, but there is controversy as to how early and what subsets of patients would benefit most due to a lack of evidence currently available.
- Delaying norepinephrine in a septic shock patient with a low MAP while first attempting to fluid resuscitate may increase morbidity and mortality, but further studies must be conducted to confirm this.
- A drop in MAP causes renal hypoperfusion and renal injury contributing to further complications and possibly worsening shock.
- It is essential to assess your patient’s fluid status and weigh the risk of renal injury when considering initiation of vasopressor therapy.