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INTRODUCTION

Vasopressors are potent pharmacologic agents that are used to increase blood pressure and mean arterial pressure by vasoconstriction, thus increasing systemic vascular resistance. They should be reserved for cases of persistent hypotension and tissue hypoperfusion after volume resuscitation has failed. Most vasopressors have proarrhythmic potential and exert effects on both the heart and vasculature. Some agents also have inotropic properties and are used to improve cardiac output, particularly in patients with left ventricular pump failure or cardiogenic shock. In patients with septic shock, the cumulative vasopressor dose to maintain blood pressure is a predictor for early death.1 Table 20-12-8 provides a summary of vasopressors and inotropic agents.

TABLE 20-1Summary of Common Vasopressors, Doses, Effects, and Contraindications

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