A Guide to the Use of Vasopressors and Inotropes for Patients in Shock

Mergoum, Anaas Moncef MD, PharmD
Rhone, Abigail Rebecca BS
Larson, Nicholas James BA
Dries, David J MD, MSE, FACS, MCCM
Blondeau, Benoit MD, MBA, FACS
Rogers, Frederick Bolles MD, MS, MA, FACS

¹Department of Surgery, 7031Regions Hospital, Saint Paul, MN, USA

Frederick Bolles Rogers, Department of Surgery, Regions Hospital, 640 Jackson Street, Mailstop # 11502v, Saint Paul, MN 55101, USA. Email: [email protected]

Received January 31, 2024

Received in revised form March 04, 2024

Accepted March 25, 2024

Journal of Intensive Care Medicine 40(7):p 726-738, July 2025. | DOI: 10.1177/08850666241246230

Shock is a life-threatening circulatory failure that results in inadequate tissue perfusion and oxygenation. Vasopressors and inotropes are vasoactive medications that are vital in increasing systemic vascular resistance and cardiac contractility, respectively, in patients presenting with shock. To be well versed in using these agents is an important skill to have in the critical care setting where patients can frequently exhibit symptoms of shock. In this review, we will discuss the pathophysiological mechanisms of shock and evaluate the current evidence behind the management of shock with an emphasis on vasopressors and inotropes.