Mixedadvanced8 min
Cardiogenic plus septic — pick the lever
Handover
Ischemic cardiomyopathy, EF 20%, new fever off a PICC. MAP 58, CO 4.2, SVR 880, PCWP 20, lactate 5.4. Too much flow for pure cardiogenic, too much SVR for pure sepsis. Mixed shock. Assign a lever to each problem — source and pressor for the pipe, inotrope for the pump — and do not pick only one religion.
Untreated tamponade, massive PE, or a crashed CPO/PAPi will keep dropping MAP and climbing lactate. Name the tracing, then move.
Goals
- · Source treated
- · Vasopressor on
- · MAP ≥ 65