What are the different types of common pressor agents used to manage shock?
Dopamine is an endogenous catecholamine that results in increased inotropy (contractility), increased chronotropy (heart rate), and vasodilation at low doses. At higher doses, dopamine results in vasoconstriction. Dopamine is often used first at low doses because it is tolerated well when given peripherally. Dobutamine is a synthetic catecholamine that results in increased inotropy and vasodilation. Norepinephrine is a potent central nervous system neurotransmitter that results in significant vasoconstriction and minimal effect on inotropy or chronotropy. Epinephrine is a natural hormone that results in increased inotropy and chronotropy. At lower doses epinephrine results in vasodilation, whereas higher infusion rates (> 0.3 μg/kg/minute) result in systemic and pulmonary vasoconstriction
Common Pressor Agents Used to Manage Shock
|Dopamine||X||X||Low dose||Higher doses|
|Epinephrine||X||X||Low dose||Higher doses|
Matthew H, Trakas EV, Su E, et al: Advances in monitoring and management of shock. Pediatr Clin North Am 2013;60(3):641-654.