What norepinephrine dose defines high-dose vasopressor therapy?

Norepinephrine >0.25 mcg/kg/min is generally considered high-dose vasopressor requirement; >0.5 mcg/kg/min is very high dose with high mortality; vasopressin addition at 0.03-0.04 units/min is recommended for norepinephrine >0.25.

What are the dopamine receptor zones for dosing?

Dopamine 1-2 mcg/kg/min: dopaminergic (renal vasodilation, historically but renoprotection not proven); 2-10 mcg/kg/min: beta-adrenergic (cardiac output); >10 mcg/kg/min: alpha-adrenergic (vasoconstriction); dopamine now rarely first-line.

Why is norepinephrine preferred over dopamine in septic shock?

SOAP II trial: norepinephrine vs dopamine in septic shock; dopamine associated with more arrhythmias (24% vs 12%); no mortality difference overall but significant harm in cardiogenic shock subgroup; norepinephrine is now first-line.

How is vasopressin used adjunctively in septic shock?

Vasopressin 0.03-0.04 units/min (fixed dose, not titrated to effect) added to norepinephrine when NE >0.25 mcg/kg/min; VASST trial: no mortality benefit overall; may reduce NE requirement and be steroid-sparing.

How should vasopressors be weaned in recovery from septic shock?

Wean vasopressors when MAP target achieved, lactate normalizing, and patient warming/perfusing; reduce lowest-dose vasopressor first; incremental weaning by 25% every 15-30 minutes; full fluid removal before weaning may help.

ICU Vasopressor Dosing Calculator (Norepinephrine/Vasopressin/Phenylephrine)

Calculates norepinephrine, vasopressin, phenylephrine, epinephrine, and dopamine doses in mcg/kg/min from infusion rates, with vasopressor equivalence table and weaning guidance for septic shock.

Use the full interactive calculator below, or

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ICU Vasopressor Dosing Calculator (Norepinephrine/Vasopressin/Phenylephrine)

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Frequently Asked Questions

What norepinephrine dose defines high-dose vasopressor therapy?

What are the dopamine receptor zones for dosing?

Why is norepinephrine preferred over dopamine in septic shock?

How is vasopressin used adjunctively in septic shock?

How should vasopressors be weaned in recovery from septic shock?