Indication
Septic / vasodilatory shock; titrate to MAP ≥ 65 mmHg.
Preparation
4 mg in 50 mL D5W (80 mcg/mL) via central line preferred.
Dilution
4 mg / 50 mL D5W → 80 mcg/mL
Rate
Start 0.05 mcg/kg/min; titrate to MAP. Typical 0.05–0.5 mcg/kg/min.
Monitoring
- • Continuous BP (arterial line preferred)
- • ECG
- • Lactate q2–4 h
- • Urine output
- • Limb perfusion / extravasation
Common errors
- • Peripheral infusion >24 h risks extravasation
- • Bolus dosing — NEVER bolus
- • Concentration mismatch in pump library
Pearls
- • First-line vasopressor in septic shock
- • Add vasopressin 0.03 U/min if escalating
- • Treat hypovolaemia first
