Vasopressor Tips in the Critically Ill

• Critically ill patients often require the administration of vasopressors to maintain adequate organ perfusion.
• A few tips to consider when administering vasopressors include:
  • Titrate to mean arterial blood pressure (MAP) or diastolic blood pressure goals.  Systolic blood pressure (SBP) is not a key driver of perfusion pressure.
  • As vasopressors also result in venoconstriction and can increase venous return, early initation may limit the need for overly aggressive fluid resuscitation.
  • Vasopressors can be safely administered through an appropriately placed peripheral venous catheter.
  • There is no maximal dose of vasopressors.
  • Consider vasopressors with a different mechanism of action in patients with persistent shock refractory to the initial vasopressor agent.

References

Legrand M, et al. Ten tips to optimize vasopressor use in the critically ill patient. Intensive Care Med. 2022; online ahead of print.