Genius is providing simple solutions. Vasopressor challenge in sepsis: Does the patient remain hypotensive after early vasopressor/ initial resus (CENSER Trial)? Is a 65 MAP enough? (1/5)
(ANDROMEDA) 1) look at CRT, if abnormal ➡️ 2) look at Diastolic BP. Two phenotypes “D” and “P”: D) Diastolic Predominant hypotension/ Normal pulse pressure; P) Low pulse pressure/ Normal DBP. (2/5)
Treatment (early vasopressor always): D) Increase vasopressor (this is vasoplegia); P) Confirm low stroke volume (LVOT VTI/ PICCO) and perform #EchoFirst, if abnormal LV/RV fix it; if normal LV/RV THEN, and ONLY then do a fluid challenge (3/5)
Took the liberty of translating @glennguru1’s algorithm and adding #VExUS. This is how I envision it: (4/5) 
Obviously by genius I was talking about Dr @glennguru1. Here is @glennguru1’s fantastic 🧵: (5/5)
