Sepsis: No response to the initial fluid bolus

Emilie Belley-Côté

How to manage a patient with sepsis not responding to the initial intravenous (IV) fluid bolus?

Emilie Belley-Côté, MD: If they do not respond to the first bolus, I tend to give another bolus. Once I have given 2 or 3 L of fluids, I move on to starting vasopressors. Then my first line tends to be norepinephrine, and then vasopressin.

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