Vasopressor therapy is referred to as low-dose or high-dose. High-dose vasopressor therapy has a number of implications for the patient. This information was provided for vasopressor support of a patient with hypotension associated with the cytokine release syndrome.
Criteria for high-dose vasopressor therapy:
(1) one or more inotropes given in a dose as shown in the tables below
(2) given for >= 3 hours
Monotherapy
Monotherapy
Dose in Paper
Could Be
norepinephrine
>= 20 µg/min
>= 10 µg/min
dopamine
>= 10 µg/kg/min
>= 20 µg/kg/min
phenylephrine
>= 200 µg/min
>= 100 µg/min
epinephrine
>= 10 µg/min
where:
• The change suggested corresponds to the equation below.
Combination Therapy
Combination with Vasopressin
Norepinephrine Equivalent Dose of Other Inotropes
yes
>= 10 µg/min
no
>= 20 µg/min
norepinephrine equivalent dose in µg/min =
= (dose of norepinephrine in µg/min) + (0.5 * (dose of dopamine in µg/kg/min)) + (dose of epinephrine in µg/min) + (0.1 * (dose of phenylephrine in µg/min))
which is referenced to the Vasopressin and Septic Shock Trial (VASST)
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