Certified-in-NeuroCritical-Care-ABEM- NCC .pdf - NCC Dumps...

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Certified in NuroCritical Care (ABEM)

Question: 710
A 55-year-old man, admitted with a Hunt and Hess grade 4aneurysmal subarachnoid hemorrhage (SAH), is now
post bleed day5 with increasing Transcranial Doppler (TCD) velocities. Meanarterial pressure (MAP) is 76 mmHg
on norepinephrine 12mcg/min, up from 5 mcg/min 24 hours earlier, intracranial pressure(ICP) is 12 mmHg, and
heart rate (HR) is 110/min with sinusvolume control mechanical ventilation receiving 7 mL/kg tidalvolume (TV)
with positive end-expiratory pressure (PEEP) of 10White blood cell (WBC) count is 11,000 with a new infiltrate
onchest x-ray (CXR); and serum creatinine has increased to 1.5mg/dL. Fluid balance over the past 24 hours is 2 L
positive withgood urine output. In addition to sending blood cultures, lactate, andstarting antibiotics, how can
volume status be assessed to determinewhether additional fluid is needed for adequate resuscitation?