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A question that junior doctors ask themselves every day: in this septic patient with hypotension, how much fluid should I give, and how much would be too much? #fluidchallenges @acutemedicine
@acutemedicine The first question is always what the physiological impact of the low blood pressure is. Ultimately it is a bunch of numbers; some people with advanced heart failure have an SBP of 80 on a good day and they tolerate that remarkably well.
Assessment should consist of the level of consciousness, peripheral perfusion (hot or cold, up to which part of the arm), urine output (and creatinine if recent values available), and fluid balance if already in hospital for a few days.
