Vasopressor & Inotrope Titration: The ICU Clinician's Reference

A working reference for every vasoactive drip you'll actually titrate: norepinephrine, epinephrine, vasopressin, phenylephrine, dopamine, dobutamine and milrinone, each with receptor pharmacology, standard concentration, starting dose, titration range and key cautions. Section 5 lays out evidence-based first-line selection by shock type straight from the trials that changed practice -- Surviving Sepsis Campaign 2021 (norepinephrine first-line, stepwise addition of fixed-dose vasopressin then epinephrine), the SOAP II trial (why dopamine fell out of first-line use, with a specific mortality signal in cardiogenic shock), and VASST (vasopressin added to norepinephrine). A dedicated section covers peripheral vs. central administration and step-by-step extravasation management with the phentolamine antidote protocol, sourced from a systematic review of published extravasation cases. Four fully worked titration cases apply the whole method. Every recommendation cites its original trial or review with a DOI or PMID. Includes a companion Excel workbook with live mcg/kg/min to mL/hr dose-rate formulas for all 6 weight-based agents.

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