Vasopressin Dosage and Titration in Sepsis

Introduction to Vasopressin Therapy

The recommended dose of vasopressin in septic shock is 0.01-0.03 units/minute, which can be initiated when norepinephrine doses of 5-15 μg/minute or more are required, with the goal of increasing mean arterial pressure or reducing norepinephrine dose, as suggested by the Intensive Care Medicine guidelines 1, 2
Vasopressin should be considered as an adjunctive agent to norepinephrine, not as initial monotherapy, according to the Intensive Care Medicine guidelines 1, 2
The use of vasopressin in patients requiring vasopressors should be accompanied by the placement of an arterial catheter as soon as possible if resources are available, as recommended by the Intensive Care Medicine and Praxis Medical Insights guidelines 1, 3
Vasopressin is not recommended as the sole initial vasopressor for the treatment of sepsis-induced hypotension, as stated by the Intensive Care Medicine guidelines 1, 2

Higher doses of vasopressin (above 0.03-0.04 units/minute) should be reserved for rescue therapy when other vasopressors have failed to achieve the target mean arterial pressure, according to the Intensive Care Medicine guidelines 1, 2
Measuring cardiac output to maintain a normal or elevated flow is desirable when using pure vasopressors like vasopressin, as suggested by the Critical Care Medicine guidelines 4, 5