ABG's and sepsis

Specialties MICU

Published

Alright, I had a patient recently who was septic, on dopamine and vasopressin. The nurse giving me report stated "he needs more fluid" and she was looking at his ABG. Is there some connection between fluid status and HCO3 or BE? I couldn't figure it out, I gave her report in the AM and she stated "oh, he still needs fluid" again looking at the ABG! Help...I'm lost!

Specializes in gen icu/ neuro icu/ trauma icu/hdu.

No I am refering to the change in a line tracing on inspiration for the ventilated patient. Increased thoracic pressure increases afterload and decreases preload resulting in reduced stroke volume in patients who are vascularly dry. This is similar to the stroke volume variance via PICCO etc though unlike the SVV there is no objective measure. CVP may swing however the changes in pressure will be so small that it would be difficult to see from the end of the bed. Again however it is difficult to make the call whether someone is vascularly dry and requires more fluids based on a single piece of data.:up:

:cheers:

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