Current and emerging therapeutic options for refractory septic shock: A systematic review

Table 4 Vasoactive drugs

Ref.	NE dosage	TP dosage	Vasopressin dosage	Dobutamine dosage
Lyu et al[15], 2022	Not specified
Ibarra-Estrada et al[16], 2023	Not specified		0.03 IU/minute if NE dose reached ≥ 0.25 μg/kg/minute
Hajjar et al[17], 2019	Infusion was started at 5 mL/hours and increased by 2.5 mL/hours every 10 minutes to reach a maximum target rate of 30 mL/hours		Ranged from 0.01 to 0.06, IU/minute
Moskowitz et al[18], 2020	Not specified
Fujii et al[19], 2020	Initial dose: 0.05 to 0.5 μg/kg/minute, Titration: Dose adjusted based on the patient's blood pressure response, aiming to maintain a MAP ≥ 65 mmHg
Sevransky et al[20], 2021	Initial dose: Start at 0.05 to 0.1 μg/kg/minute. Titration: Adjust as necessary to achieve a MAP ≥ 65 mmHg
Wang et al[21], 2022	NE greater than or equal to 15 μg/minute (Norepinephrine ≥ 15 μg/minute)
Cherukuri et al[22], 2019	Not specified
Douglas et al[23], 2020	Initial dose: 0.05 to 0.1 μg/kg/minute; Titration: Dose increased based on the patient's response, often up to 0.5 μg/kg/minute or higher if necessary to achieve and maintain a MAP of ≥ 65 mmHg
Morelli et al[24], 2008	Continuous infusion: 0.9 mg/kg/minute to maintain MAP (MAP) at 70 mmHg	Single dose: 1 mg administered as a bolus infusion		Initial dose: 3 mg/kg/minute. Titration: The dose was progressively increased in increments of 1 to 3 mg/kg/minute to reverse the anticipated decrease in mixed SvO2 caused by the infusion of TP
Albanèse et al[25], 2005	Initial Dose: 0.3 μg/kg/minute. Titration: Increased by increments of 0.3 μg/kg/minute at 4-minute intervals to achieve a target MAP of 65 to 75 mmHg	Initial bolus: 1 mg (equivalent to 0.03-0.04 UI/minute). Second bolus: An additional 1 mg was given if the MAP remained below 65 mmHg after 20 minutes
Hyvernat et al[26], 2016	Initial dosage: The starting dose typically ranged from 0.05 to 0.5 μg/kg/minute and was titrated based on the patient's response. Titration: Doses were adjusted as needed to achieve the target MAP
Annane et al[27], 2002	Systolic arterial pressure lower than 90 mmHg for at least 1 hours despite adequate fluid replacement and administration of more than 5 μg/kg of dopamine, or current treatment with epinephrine or NE
Morelli et al[35], 2009	NE 15 μg/minute	Terlipressin 1.3 μg/kg/hour	Vasopressina 0.03 U/minute
Lv et al[36], 2017	Not specified
Russell et al[32], 2008	5 μg of NE per minute
Russell et al[31], 2009	5 μg of NE per minute
Venkatesh et al[33], 2019	Not specified
Yildiz et al[37], 2011	Not specified
Keh et al[30], 2003	Not specified
Keh et al[38], 2016	Not specified
Annane et al[34], 2018	0.5 to 1.0 µg/kg/minute to maintain MAP
Liu et al[28], 2018	starting dose of 4 µg/min, which could be titrated up to a maximum of 30 µg/minute	20 µg/hour, with the option to titrate up to a maximum of 160 µg/hour
Xiao et al[29], 2016	From 0.5 to 2.22 µg/kg/minute to maintain MAP	1.3 mg/kg/hour

MAP: Mean arterial pressure; NE: Norepinephrine; SvO₂: Oxygen venous saturation; TP: Terlipressin.