(1) Later that day, he developed cardiogenic shock, requiring numerous pressor agents and the aortic balloon pump to maintain his cardiac output.(2) This finding suggests a direct pressor effect in patients with normal function of the posterior lobe of the pituitary gland.(3) The pressor effects of epinephrine may be counteracted by medications such as phentolamine and phenoxybenzamine.(4) If a pressor agent must be used, a direct-acting alpha-adrenergic agonist such as norepinephrine is preferable because it acts without releasing intracellular amines.(5) Women destined to develop HIP reportedly lose refractoriness to the pressor effects of infused angiotensin II by wk 18 of pregnancy, whereas calcium supplementation increases refractoriness to angiotensin.(6) Almost any infusate can be instilled at a rapid rate through an intraosseous line, including blood and blood products, Plasmanate, glucose, crystalloids, pressor agents including epinephrine, dopamine and dobutamine, and atropine.(7) Importantly, the doses used for antidiuresis are markedly lower than those needed for pressor support.(8) High erythropoietin levels can elevate blood pressure either via a polycythemia/hyperviscosity mechanism or by direct pressor effects.(9) Vascular pressor responses to hypoxia are increased in patients with obstructive sleep apnea.(10) Teramoto et al raise the interesting point that an increase in nitric oxide is responsible for a poor or absent hypoxic pressor response as a cause of hypoxemia.(11) With a half-life of 10 to 35 minutes, the pressor effects after a single dose last about 30 to 60 minutes.(12) Such protective action on pressor response, if any, may appear as an alleviation of reduced coronary flow in isolated hearts.(13) There is usually no need to taper pressor drugs, antibiotics, nutrition, or most other critical care treatments.(14) Pediatric Advanced Life Support guidelines for VT / VF are consistent with the adult guidelines, except that epinephrine is the only recommended pressor agent.(15) None required pressor support or steroid treatment for hypotension.(16) L-NAME at pressor doses tends to decrease urine volume compared with control, whereas L-NAME at a subpressor dose induces diuresis.
