1. Treating Vasodilatory Shock in the ICU

3. Case Study: Admitting Presentation

4. Case Study: Lab Findings, Medications

5. Recommendations

6. Hospital Day 1

7. Additional Recommendations

8. At Least 2 of These 4 Criteria = SIRS

9. Hospital Day 2

10. Recommendation: Within 3 Hours of Time of Presentation*

11. Recommendation: Within 6 Hours of Time of Presentation

12. Fluid Therapy Recommendations

13. Why ICU?

14. Defining Shock

15. Differential Diagnosis: What Type of Shock?

16. Types of Shock

17. Hemodynamics in Vasodilatory Shock

18. Septic Shock: Scope of the Problem

19. Later That Day…

20. Delayed Transfer to ICU: Quantifying the Risk

21. Serum Lactate Levels

22. Blood Lactate Predicts Survival in 126 Patients With Shock From Various Origins

23. Importance of Dynamic Fluid Assessment

24. Goal-Directed Fluid Therapy Guided by Dynamic Assessment of Fluid Responsiveness

25. Arrival in ICU

26. Vasoactive Medications in Septic Shock

27. Prognosis for Patients With Treatment-Refractory Vasodilatory Shock

28. Outcomes for Patients Requiring High-Dose Vasopressors

29. Why Increased Mortality With High-Dose Vasopressors?

30. Systems Involved In Restoring Effective Blood Pressure

31. Angiotensin II Trials

32. Angiotensin II for the Treatment of Vasodilatory Shock: ATHOS-3

33. Angiotensin II: Current Status

34. Tying Up Our Case

35. Opportunities to Improve Care

36. Take-Home Points

37. Abbreviations

38. Abbreviations (cont)

39. Abbreviations (cont)