Fluid Responsiveness Evaluation in Sepsis-associated Hypotension

Exclusion Criteria

• •1. Primary diagnosis of: acute cerebral vascular event, acute coronary syndrome, acute pulmonary edema, status asthmaticus, major cardiac arrhythmia, drug overdose, or injury from burn or trauma
• •2. Known aortic insufficiency, or aortic abnormalities
• •3. Hemodynamic instability due to active gastrointestinal hemorrhage
• •4. Patient has received \>3 liters of IV fluid prior to study randomization
• •5. Requires immediate surgery
• •6. Patient transferred to the ICU from another hospital unit
• •7. Do not attempt resuscitation (DNAR or DNR) order
• •8. Advanced directives restricting implementation of the resuscitation protocol
• •9. Contraindication to blood transfusion
• •10. Attending clinician deems aggressive resuscitation unsuitable
• •11. Transferred from another in-hospital setting
• •12. Not able to commence treatment protocol within 1 hour after randomization
• •13. Known intraventricular heart defect, such as ventral septal defect or atrial septal defect
• •14. Use of additional hemodynamic monitoring involving stroke volume variation (SVV) to determine fluid responsiveness
• •15. Seizure in the last 24 hours
• •16. Prisoner
• •17. Pregnancy
• •18. Age \<18
• •19. Known allergy to sensor material or gel
• •20. Inability or contraindication to doing a passive leg raise with both extremities, such as inability to interrupt venous compression boots
• •21. Patient has an epidural catheter in place
• •22. Suspected intra-abdominal hypertension
• •23. Inability to obtain IV access
• •24. Diabetic ketoacidosis
• •25. Hyper-osmolarity syndrome
• •26. Patient uncouples from treatment algorithm
• •27. Patient should be excluded based on the opinion of the Clinician/Investigator