REBOOT - 6. Vasopressors - Part 1

Vasopressors serve as critical tools for increasing vascular tone and systemic vascular resistance in patients experiencing shock. Effective management requires a nuanced understanding of adrenergic receptor activity, where norepinephrine acts as a balanced first-line agent for undifferentiated shock due to its combined alpha and beta-1 effects. Rather than fixating on arbitrary blood pressure targets, clinicians should titrate therapy to objective markers of organ perfusion, including mental status, urine output, and lactate trends. The case of Ms. Gonzalez illustrates the practical application of these principles, highlighting the necessity of push-dose pressors during high-risk procedures like intubation and the safety of peripheral administration when using appropriate IV sites and protocols. Ultimately, successful resuscitation relies on a closed-loop approach, where interventions are continuously reassessed against the patient's clinical response to ensure adequate oxygen delivery.