Fig. 2

Early septic shock in central venous line-related bloodstream infection. Spontaneously breathing patient. Severe hypotension. Very small IVC end-expiratory diameter (aright side) and marked inspiratory collapse (a, M-mode scanning, left side) are in favor of severe hypovolemia. Subsequent volume loading (colloids 1,000 ml, crystalloids 300 ml), improves SAP. This is paralleled by a progressive increase in IVC end-expiratory size (b, c, red double-headed arrows). IVC inferior vena cava, RA right atrium, INSP inspiratory phase of respiratory cycle, SAP systemic arterial pressure, HR heart rate