The old adage was “levophed, leave ‘em dead.” Now it’s “who’s the dope that started dopamine?” Although current evidence suggests superiority of levophed (norepinephrine) in septic shock the choice is not always simple and must be tailored to specific hemodynamic goals. A head to head trial comparing norepinephrine and dopamine is ongoing.
A review in Chest discusses these issues as well as other pressors, including an update on the adjunctive use of vasopressin infusions.
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