Abstract
When fluid therapy fails to restore adequate arterial pressure, therapy with vasopressors should be started. Dopamine and norepinephrine are both effective to increase blood pressure. In some patients norepinephrine may be a more effective agent. In case of inadequate organ perfusion dobutamine can be associated to the vasopressor agent used. Both drugs can be titrated separately to maintain arterial pressure and cardiac output. Epinephrine can be considered for refractory hypotension or to increase cardiac output, although adverse effects are common. Clinical experience with phenylephrine is limited.
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