Table 2.
NE equivalentb (μg/kg/min) | Vasopressin (U/min) | Methylene bluec (mg/kg) | Angiotensin II (ng/kg/min)d,e | Hydroxycobalaminf (g) |
---|---|---|---|---|
If you have just titrated NE to: | Make sure vaso is: | Administer | And titrate ang II to: | Administer |
< 0.05 | < 0.07 | No | Ang II offc | No |
0.05–0.1 | < 0.07 | Yes | 10c | Yes |
0.1–0.15 | < 0.07 | Yes | 20 | Yes |
0.15–0.20 | < 0.07 | Yes | 30 | Yes |
> 0.20 | < 0.07 | Yes | 40 | Yes |
aTitration driven by NE dosing, based on MAP goals
bNE equivalent doses represented in Table 1
c2 mg/kg IVP over 5 min or as IVPB over 20–60 min
dAng II maximum dose is 40 ng/kg/min
eAlways initiate Ang II at 10 ng/kg/min. In patients who are hyper responders or extremely hemodynamically dependent on Ang II, consider titrating down Ang II to 5 ng/kg/min before titrating off
f5 g infused over 15 min