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Case Study - Adult - Pneumonia - Septic Shock


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Case Study - Adult - Pneumonia - Septic Shock

  1. 1. Pneumonia - Septic Shock Presentation 42 y/o male BP 102/41 CVP 10 Initial Diagnosis Pneumococcal The Measure of Life
  2. 2. Pneumonia - Septic Shock BP 102/42 (61) CI 9.3 HR 129 SVR The Measure of Life
  3. 3. Pneumonia - Septic Shock Treatment Minimal fluid needed as it will only make his lungs wetter. Vasoconstrictor (phenylephrine) "Do you think he needs the vasoconstrictor?” "Do you think he needs to go to ICU?" Summary Legionaires disease with septic shock! Conclusion USCOM helped with rapid measurement and recognition of the hyperdynamic circulation and confirmed appropriate The Measure of Life
  4. 4. Aortic Stenosis? How can I know when a high CO/CI is due to Aortic Stenosis and not a Hyperdynamic Circulation such as Septic Shock? On Echocardiogram, Pmn(mmHg) is used to calculate the mean pressure gradient across a valve. < 25mmHg = Mild Aortic Stenosis But Pmn is dependent upon the flow. Normal upper limit = 2mmHg per litre of CI. In a normal adult circulation CI 2.4-4.2, Pmn usually <9 In our high CO state of CI 9.3, Pmn =13mmHg <19mmHg = not Aortic The Measure of Life