RESUS

ResponseTypically commence following ~2L of crystalloid (20-30 mL/kg IV)
Noradrenaline (6mg in 100 mL 5% glucose: start at 3 mics/min = mL/h)

• Maintains coronary perfusion by increasing diastolic BP through systemic arterial vasoconstriction
• Increases preload by venoconstriction
• Adrenaline reasonable alternative (CAT study - Norad = Adrenaline outcomes)

Low cardiac output (eg septic cardiomyopathy) consider inotrope (Dobutamine/Adrenaline)

• ARISE/PROMISE/PROCESS - No benefit of early goal directed therapy with protocolised dobutamine

Refractory hypotension add Vasopressin 2 U/h
Fails Fluids + Vasopressors add Hydrocortisone 200 mg IV (Daily?)

Endpoints: HR <100, BP>90, MAP >65, Good end organ perfusion, Normalising lactate, Urine ouptut >0.5 mL/kg/h
Taken from LITFL as old answer was very dated