Guidelines for Complications of Cancer Treatment Vol VIII Part B

o S – Strong Recommendation –CommitteeRecommendso W – weak recommendation Committee Suggestso 2004 (alphabet): Grade of evidence as in 2004guidelinesInitial resuscitation and infection issues Immediate resuscitation when hypotension or serumlactate > 4 mmol/L;o Do not delay pending ICU admission (1C) S Resuscitation goals (1C) So CVP 8–12 mmHg (if MV 12-15 mmHg)o Mean arterial pressure > 65 mm Hgo Urine output > 0.5 mL/kg/hro ScvO 2> 70% or SvO 2> 65% 2004 B & B If ScvO2 target not achieved (2C) Wo Consider further fluido PRBCs to hematocrit of > 30% and/oro Start dobutamine infusion, maximum 20 μg/kg/minDiagnosisObtain cultures before antibiotics provided this does notsignificantly delay antimicrobial administration (1C) So Obtain two or more BCso One or more BCs should be percutaneousoOne BC from each vascular access device in place> 48 hrs77