Sepsis, N/IICU — Vasopressors — Clinical Pathway: ICU and Inpatient

Suspected Sepsis Clinical Pathway — N/IICU

Vasopressors

  • Consider placement of arterial line, central venous line
  • Start dopamine infusion at 5 mcg/kg/min
    • Alternative pressor choices per attending neonatologist preference
      (e.g., dobutamine, epinephrine, norepinephrine, milrinone, vasopressin)
  • Titrate dopamine infusion based on MAP goals
  • If dopamine infusion > 10-15 mcg/kg/min:
    • Consider initiation of hydrocortisone
    • Order epinephrine infusion – starting dose 0.03 mcg/kg/min
  • Give packed red blood cell transfusion if hemoglobin < 10 g/dL
  • Consider other etiology causing or contributing to shock
    (see Management of Refractory Shock)