ICU Vivas · Resuscitation
Blood gas and lactate in septic shock
A CICM cross-table data viva. The candidate is handed a venous blood gas from a patient in septic shock and must interpret the acid–base disorder, the lactate, and the venous saturation, then translate the numbers into a resuscitation plan.
On this page
Study tools
Target exams
CICMFFICMEDIC
Prompt
A venous blood gas with lactate drawn from a shocked patient — interpret and act.
Stimulus
A 63-year-old man is hypotensive and mottled with a presumed biliary source. A venous blood gas is drawn from a central line:
| Variable | Value | Reference |
|---|---|---|
| pH | 7.24 | 7.35–7.45 |
| PvCO₂ | 28 mmHg | 41–51 |
| Bicarbonate | 13 mmol/L | 22–26 |
| Base excess | −12 | −2 to +2 |
| Lactate | 5.8 mmol/L | 0.5–2.0 |
| Sodium | 138 mmol/L | 135–145 |
| Chloride | 108 mmol/L | 98–107 |
| Glucose | 9.2 mmol/L | |
| ScvO₂ | 58% | more than 70 |
Take ninety seconds, then present a structured interpretation.[1]
References4ShowHide
- [1]Singer M, Deutschman CS, Seymour CW, et al. The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA, 2016.PMID 26903338
- [2]Evans L, Rhodes A, Alhazzani W, et al. Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2021. Intensive Care Medicine, 2021.PMID 34599691
- [3]Rivers E, Nguyen B, Havstad S, et al. Early goal-directed therapy in the treatment of severe sepsis and septic shock. New England Journal of Medicine, 2001.PMID 11794169
- [4]Rowan KM, Angus DC, Bailey M, et al. Early, Goal-Directed Therapy for Septic Shock — A Patient-Level Meta-Analysis. New England Journal of Medicine, 2017.PMID 28320242