Indication
Adjunct to noradrenaline in septic / vasoplegic shock.
Preparation
20 U in 100 mL D5W or NS (0.2 U/mL) via central line.
Dilution
20 U / 100 mL → 0.2 U/mL
Rate
Fixed 0.03 U/min (range 0.01–0.04). Do NOT titrate above 0.04 U/min.
Monitoring
- • Continuous BP, MAP
- • Na⁺
- • Digital, mesenteric, coronary perfusion
- • Lactate
Common errors
- • Bolus dosing → cardiac arrest
- • Titrating above 0.04 U/min
- • Peripheral infusion
Pearls
- • Catecholamine-sparing — reduces noradrenaline requirement
- • Risk of ischaemic complications increases above 0.04 U/min
