Anestéziológia a intenzívna medicína 1/2026
How many vasopressors is too many?
The dosing of vasopressors in refractory vasodilatory shock and the question of where the limit of meaningfulness lies remains an ever-relevant topic. Even within this field, however, we recognize many shades, and over the decades our perspective has changed according to the “illumination” provided by our understanding of the problem and by our ability to influence potentially reversible causes. Especially in patients with a potentially removable cause of fatal hypotension, we look for a “bridge”, buy time and push the boundaries of what is possible, sometimes beyond the horizon of meaningfulness. What dose of norepinephrine is still safe? 0.5 μg/kg/min? 1.0? 2.0? And how about 6 μg/kg/min? What exactly does the term safe mean for a dying patient?
Keywords: vasopressors, hypotension, vasoplegia, vasodilatory shock, distributive shock, refractory shock, catecholamines, angiotensin II
