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November 21, 2025 48 mins

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:


Instagram: https://www.instagram.com/icuboy_meded/

Facebook: https://www.facebook.com/share/1Dg1ZTyfsN/

TikTok: https://www.tiktok.com/@icuboy_meded

Threads: https://www.threads.com/@icuboy_meded

X: https://x.com/icuboy_meded


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:

CONNECT 📸 Connect on Instagram: https://www.instagram.com/therapidresponsern/ 📚 Check out my course: https://www.rapidresponseandrescue.com/learnmore 🧑‍💻Check out my website: https://www.rapidresponseandrescue.com/ 📬 Subscribe to my newsletter: https://www.rapidresponseandrescue.com/login 🎁 Affiliation and discounts: https://www.rapidresponseandrescue.com/therapidresponsern ✅ Earn CE’s for listening to podcasts through RNegade: https://rnegade.thinkific.com/?ref=d9d541 SAY THANKS 💜Leave a review on Apple Podcasts: https://podcasts.apple.com/ca/podcast/rapid-response-rn/id1535997752 💚Leave a rating on Spotify: https://open.spotify.com/show/55LQqeDg6XFeixvZLEp4xE ⏱️ To get the FREE Rapid Response RN Assessment Guide and the coupon code for $10 off the cost of the course, message Sarah on Instagram @TheRapidResponseRN and type the word PODCAST! This episode was produced by Podcast Boutique https://www.podcastboutique.com

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