Case of the Week — November Case #3

52 y/o AAM presents to the ED via EMS with respiratory distress. He has been increasingly short of breath over the past 3 days. He denies CP, N/V/D. Admits to subjective fevers and "feeling cold" + cough productive of brown sputum. He was recently admitted to the hospital MICU with respiratory distress. PMHx: sarcoidosis, stage 4; anemia PSHx: none FamHx: DM, HTN, cancer and anemia SocHx: denies ETOH, tobacco or drug use Meds: prednisone plus "others" Allergies: levaquin PE: BP 135/88, P 165, R 36, POx 85% on NRBM GEN: ill appearing, respiratory distress, diaphoretic CHEST: fine crackles bilaterally with labored respirations, retractions, tachypnea CV: tachycardic, RR, no M/R/G Pt is started on nasal BIPAP and given IVF. Bedside ultrasound is obtained to look at his IVC to determine his fluid status. What does this say about his fluid status? What is his likely CVP? Thanks to David Imbt who submitted this case!