ICU Vivas · Shock states
Data viva — a haemodynamic profile in shock
A data-interpretation viva in which the candidate uses the cardiac output, the SVR, the wedge pressure and the ScvO2 to classify the shock into its type, identify the failed determinant, and direct the management.
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CICMFFICMEDIC
Prompt
A haemodynamic dataset from a shocked patient — the cardiac output, the systemic vascular resistance, the pulmonary-artery occlusion pressure and the central venous oxygen saturation — to be interpreted and classified.
Stimulus
You are shown the haemodynamic dataset of a shocked patient:
| Variable | Value | (normal) |
|---|---|---|
| Cardiac index | 1.9 L/min/m² | (2.5–4.0) |
| Systemic vascular resistance | 1900 dyn·s·cm⁻⁵ | (800–1200) |
| Pulmonary-artery occlusion pressure | 24 mmHg | (6–12) |
| Central venous O₂ saturation | 58 per cent | (>70) |
| Lactate | 5.2 mmol/L | (0.5–1.6) |
Interpret the profile.[1]
References3ShowHide
- [1]Reynolds HR, Hochman JS. Cardiogenic shock: current concepts and improving outcomes. Circulation, 2008.PMID 18250279
- [2]Bersten AD, Soni N (eds) Oh's Intensive Care Manual. 8th edition, Elsevier, 2018.
- [3]Marino PL The ICU Book. 4th edition, Lippincott Williams & Wilkins, 2014.