When to Add Vasopressin to Norepinephrine?

Thus, my approach is usually to add a fixed, low-dose vasopressin infusion of 0.03 units/minute when the norepinephrine is running at a low rate (i.e. ~10 mcg/min). The goal of the vasopressin isn't necessarily to increase the blood pressure but rather to improve renal function.

When do you add vasopressin?

Vasopressin, also known as antidiuretic hormone, is released within the body in response to hypotension or hypovolemia. In septic shock, vasopressin levels are elevated, then become depleted by 96 hours, with one study identifying 32% of patients having relative vasopressin deficiency (≤ 3.6 pg/mL).

Why is vasopressin used with norepinephrine?

Concomitant vasopressin administration has been seen to improve vascular tone, MAP, urine output, and creatinine clearance. Additionally, vasopressin acts as a catecholamine sparing agent, by effectively reducing the dosage of norepinephrine required.