Initial Resuscitation, BP Goals, and ICU Admission
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Initial fluid bolus of 30ml/kg of IV crystalloid within the first 3 hours of resuscitation
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Use of dynamic measure to guide fluid resuscitation is recommended.
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Dynamic parameters include response to a passive leg raise or a fluid bolus, using stroke volume (SV), stroke volume variation (SVV), pulse pressure variation (PPV), or echocardiography.
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For patients with elevated lactate, resuscitating to decrease lactate levels is suggested
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For patients with septic shock, capillary refill time can be used to guide resuscitation
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For patients with septic shock on vasopressor, a mean arterial pressure of 65mm Hg is recommended
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For patients requiring ICU admission, admission within 6 hours is recommended
Reference: Evans, Laura et al. “Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2021.” Critical care medicine vol. 49,11 (2021): e1063-e1143. doi:10.1097/CCM.0000000000005337