Treatment of Sepsis in Septic Shock with Cardiac Dysfunction and Persistent Hypoperfusion

Clinical scenario

This protocol addresses adults in septic shock who also have cardiac dysfunction with persistent hypoperfusion — despite having already achieved adequate volume status and arterial blood pressure. When circulatory failure continues under these conditions, a targeted escalation of pharmacological support is required.

Treatment approach (partial)

The protocol outlines specific adjustments to circulatory support — including guidance on agents such as norepinephrine — for this clinical situation. The complete options, their conditions for use, and the decision framework are contained in the full structured protocol.

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References

DOI: 10.1097/CCM.0000000000005337

For adults with septic shock and cardiac dysfunction with persistent hypoperfusion despite adequate volume status and arterial blood pressure, we suggest either adding dobutamine to norepinephrine or using epinephrine alone.

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