A 42-year-old man admitted with a high fever and leukocytosis is transferred to the intensive care unit in shock. Which of the following is a common finding in the early stages of septic shock?
Which of the following is an appropriate initial therapy for both septic shock and cardiogenic shock?
- prophylactic antibiotics
- beta blockers
- volume resuscitation with crystalloid fluids
- mechanical ventilation
- diuretics
Answer(s): C
Explanation:
The usual early hemodynamic response to sepsis is a hyperdynamic circulation. This includes tachycardia, elevated cardiac output, and decreased systemic resistance. Septic shock may then progress with intractable hypotension, metabolic acidosis, reduced cardiac output, oliguria, and death. The initial resuscitation of patients with all forms of shock requires rapid expansion of circulating blood volume to help maintain BP and tissue perfusion. This is usually achieved with the infusion of crystalloid fluids. When septic shock is suspected, cultures of blood, urine, and other sources along with antibiotic therapy targeted toward the most likely source is critical. Mechanical ventilation may be required when altered mental status, acidosis, and hypoxia are present. Beta-blockers and diuretics may have specific indications that cardiac ischemia and pulmonary edema are present