NorEpinephrine/NorAdrenaline (Levophed) is one of the most widely used medications in Critical care, Emergency medicine and is used by some EMS systems around the world.
Mechanism of Action:
Endogenous catecholamine;
Potent α and β adrenergic stimulating properties
Increased SVR; Increased Chronotropy; Increased Inotropy; Increased Cardiac output.
Indications:
Hemodynamically significant Hypotension (<70mmHg)
Cardiogenic shock
Septic/ Neurogenic shock refractory to fluid bolus.
Post Resuscitation Care- AHA Guidelines
Dose:
Continues Infusion
0.1-0.5 mcg/kg/min (AHA Guidelines)
Dosing is typically organizational dependant.
Titrate to MAP of 65, signs of improved perfusion.
⚠️ Precautions:
Increases Myocardial O2 demand
Extravasation causes tissue Necrosis.
Central line preferred route if available.
⛔️ Always follow organizational protocols
Disclaimer: This video is for educational purposes only and is not intended as medical advice. While we strive for 100% accuracy, errors may occur, and medications or protocols may change over time.