商品名:Norepinephrine ®
處置代碼:PUMP4
規格:4mg/4ml/amp
適應症:升壓劑
泡法:8amp in D5W 500ml, 64 mcg/mL
劑量:
Shock: 0.023-0.9 ml/kg/hr (Max 3.09)
60kg劑量1.38-54ml/hr (max 185.4 ml/hr)
當 NE 劑量 0.25–0.5 μg/kg/min (約60公斤30 ml/hr) 仍無法達到目標:建議加 Vasopressin,而非單純繼續加大 NE 劑量(轉折點1.13mcg/kg/min)
ACLS: 0.09-0.47ml/kg/hr
60kg劑量5.4-28.2 mL/hr
滴數:0-30'' (>30cc/hr建議加上第2種升壓劑)
外滲 warm compress
NE dose 已達 0.25–0.5 mcg/kg/min
且 MAP/perfusion 仍不足
→ 優先加 Vasopressin
若 cold shock / low CO:
- cool extremities
- weak pulse
- narrow pulse pressure
- low EF by echo
- ScvO₂ low
- lactate persistently high despite MAP adequate
→ 加 Dobutamine 2.5–20 mcg/kg/min
若 NE + Vasopressin 仍不足
或 mixed shock / severe myocardial dysfunction
→ 考慮 Epinephrine
若 NE ≥0.25 mcg/kg/min 且仍需升壓
→ 考慮 Hydrocortisone 200 mg/day