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EMCrit 161 – The New Fluid Assessment in Sepsis with Jean-Francois Lanctot

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Jean-Francois Lanctot along with his partner in crime, Maxime Valois, has markedly advanced the field of resuscitative ultrasound. The two of the them also created Echo-Guided Life Support (EGLS) and the Shock Echo app.

Today, Jean-Francois and I discuss the current state of fluid assessment and treatment.

TLDR Take-Home Points

  1. Rule out obstruction to Venous Return (Can the Right Ventricle Take Volume Loading)
  2. Look for Left Ventricular Failure (Can the Left Ventricle Take Volume Loading)
  3. Correct Vascular Tone
  4. Only then, Decide if the Patient may be Fluid Responsive

srrezaie

Marik and Bellomo on the Fluid Management of Severe Sepsis

from Br J Anaesth

See this amazing fluid physiology lecture from the Ultrasound Podcast Site

An Integrated Approach to Ultrasound-Guided Fluid Management

Additional New Information

 

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Scott Weingart, MD FCCM
Latest posts by Scott Weingart, MD FCCM (see all)

Cite this post as:

Scott Weingart, MD FCCM. EMCrit 161 – The New Fluid Assessment in Sepsis with Jean-Francois Lanctot. EMCrit Blog. Published on November 20, 2015. Accessed on April 26th 2025. Available at [https://emcrit.org/emcrit/new-fluid-assessment-sepsis/ ].

Financial Disclosures:

The course director, Dr. Scott D. Weingart MD FCCM, reports no relevant financial relationships with ineligible companies. This episode’s speaker(s) report no relevant financial relationships with ineligible companies unless listed above.

CME Review

Original Release: November 20, 2015
Date of Most Recent Review: Jul 1, 2024
Termination Date: Jul 1, 2027

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Moab
Moab
9 years ago

Many times I have seen a patient with undifferentiated shock and PA atheter can be so helpful in these patients. A lot of the sick pts we see have poor windows especially on a vent, or they may have a history of cardiomyopathy and without a PA catheter it can be hard to manage this specific subgroup of pts. An ultrasound has limitations and we cannot estimate pressures with this in all patients! The trials that look at PAC use do not address the pt with severe undifferentiated shock they were excluded. It can definitely be helpful we just need… Read more »

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Carole Cahaney, BSN, RN, Sepsis Coordinator
Carole Cahaney, BSN, RN, Sepsis Coordinator
9 years ago

Scott,
What about the patient with an active head bleed who is also exhibiting septic shock? How aggressive should the fluid resuscitation be?

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