First-line agents by shock type and infusion ranges.
Noradrenaline (NA)
- • First-line for septic shock
- • 0.05-0.5 mcg/kg/min (up to 1+)
- • Central line preferred; peripheral acceptable short-term via large vein
Adrenaline
- • Anaphylactic shock; second-line in septic shock
- • 0.05-0.5 mcg/kg/min
- • Watch lactate (β2-mediated rise)
Vasopressin
- • Adjunct in septic shock when NA >0.25 mcg/kg/min
- • Fixed dose 0.03 U/min
- • Caution in IHD
Dobutamine
- • Inotrope for cardiogenic shock with low CO
- • 2.5-20 mcg/kg/min
- • Can cause hypotension and tachyarrhythmia
Phenylephrine
- • Pure α — useful in tachyarrhythmia where NA contraindicated
- • 0.5-5 mcg/kg/min
Pearls
- • Target MAP ≥65 in most adults
- • Resuscitate volume before / alongside pressors
- • Wean noradrenaline first, vasopressin last
Educational support only — follow institutional ICU protocols.
