New insights into the management of severe sepsis and septic shock

Vasoactive agents Vasopressors should be administered whenhypotension is persistent or mean arterial bloodpressure less than 65 mm Hg, regardless of thecentral venous pressure, because in the presenceof hypotension, organ perfusion cannot bemaintained with fluids alone. Norepinephrine may be more effective incorrecting hypotension in septic shock whileavoiding the potential tachycardia induced bydopamine In the patient with refractory hypotension,vasopressin deficiency should be considered