Your pneumonia patient is hypotensive, tachycardic, and not responding to fluids… what did you miss? It could be sepsis-induced cardiomyopathy, a common under-recognized shock state you could see at the bedside.

In this episode, Dr. Mahmoud Ibrahim MD and host Sarah Lorenzini use a case study to highlight how nurses, intensivists and the ICU team can work together to recognize the signs of sepsis-induced cardiomyopathy early and give patients a better chance at recovery. You'll learn the diagnostic clues that your patient’s heart is in trouble, how to approach controversial treatments like sodium bicarb, and what has to happen before intubation in a dual shock state.

Topics discussed in this episode:

What the initial bedside assessment says about the patient
Treatment priorities for the intensivist and nurse
Signs that point to more than just sepsis
Why fluids aren’t always the answer
Blood pressure management: vasopressors and inotropes
Pathophysiology of sepsis-induced cardiomyopathy
How a sepsis-induced cardiomyopathy diagnosis changes treatment
The vasopressin debate for sepsis-induced cardiomyopathy
Clues your intervention isn’t working and what to do next
How to prepare the patient for high-risk intubation
What you need to know about administering sodium bicarb
Why collaboration matters at every step for patient recovery

Connect with Dr. Ibrahim:

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Learn more about the different phenotypes in sepsis induced cardiomyopathy:

https://journal.chestnet.org/article/S0012-3692(25)05143-8/abstract

Mentioned in this episode:

Rapid Response Academy Winter 2026 Cohort

https://www.rapidresponseandrescue.com/rra