Case Study – Balancing Fluid & Pressors

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Presentation transcript:

Case Study – Balancing Fluid & Pressors Clinical Scenario 42 y/o male, paraplegic, large wound to coccyx, admitted for septic shock. Received 6L fluid overnight, unable to be weaned off low-dose levophed. CVP 8-10, MAP 55-65, UOP>30ml/hr Actions Taken/ Change of Clinical Approach Cheetah monitor put on pt to assess if pt was fluid responsive due to inability to wean off levophed. PLR Dynamic Assessment initiated & PLR results = ∆ SVI 15.2% ≥ 10% SVI indicated patient was likely fluid responsive 1 liter LR was ordered to be given, and PLR to be repeated in 1 hour after infusion complete Second PLR result = ∆ SVI 6.7% indicated patient was not fluid responsive, however patient was able to be weaned off Levo entirely. Here’s another case study to illustrate real clinical life application of the Cheetah. This study shows how the Cheetah monitor can help titrate the both fluids and pressors – something we do every day at the bedside. Key takeaway: ONE liter made the difference between this patient staying on Levo or being weaned off. How often are you asking the question, does my patient need fluid? Or Pressors?