No ceiling effect but for whatever reason in our shop when we get to around 0.3 norepi were looking hard at other things. Around 0.4 norepi with 4 vaso were usually throwing the kitchen sink at them with epi, steroids, cyanokit or blue depending obviously on the specifics of the patient...
At that stage and that level of support i would say 1 week mortality is over 50%
So im surprised this 80 yo rallied so well.
Fluids are voodoo. No one agrees. And we dont understand fluid balance enough.
Without tee or some measure of intravascular volume theres no way we can comment further on your pt.
But 8litres is very far outside the norm in our place anyway