# Case Report: Complete recovery of a patient with occult septic shock following supranormal vasopressor and inotrope therapy informed by the novel ‘pressure field method’ for managing hemodynamics

## TL;DR

A patient with severe septic shock recovered fully after treatment using a new method called the 'pressure field' to guide high-dose vasopressor and inotrope therapy.

## Contribution

The paper introduces the novel 'pressure field method' for individualized hemodynamic management in septic shock.

## Key findings

- A patient with occult septic shock and 10% ejection fraction recovered completely using the pressure field method.
- High-dose vasopressors and inotropes were safely administered based on pressure field-guided titration.
- Urine output was maintained without ileus during treatment.

## Abstract

Complete recovery of a patient with occult septic shock and left ventricular ejection fraction of 10% was achieved following management informed by continuous measurement and visualization of the patient’s ‘pressure field’. The ‘pressure field’ visualizes mean perfusion pressure as the product of stroke volume and a beat-to-beat measure of vascular tone, termed systemic elastance. The pressure field guided the titration of inotropes and vasopressors at high doses, including norepinephrine equivalents >2.5 μg/kg/min, to restore the patient’s estimated pre-morbid pressure field values. Urine output was maintained throughout with no ileus. We hypothesize that pressure field management assists in individualizing care for patients with septic shock and improves outcomes.