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Drugs with inotropic and vasopressive effects used for management of a potential pediatric organ donor

Drugs with inotropic and vasopressive effects used for management of a potential pediatric organ donor

Drug	Dose	Comments
Milrinone	0.25 to 0.75 micrograms/kg per minute IV	Loading dose: 50 micrograms/kg Hypotension can occur
Dopamine	2 to 20 micrograms/kg per minute IV	Titrate to desired blood pressure
Dobutamine	2 to 20 micrograms/kg per minute IV	Titrate to desired blood pressure
Epinephrine	0.1 to 1 micrograms/kg per minute IV	Titrate to desired blood pressure
Norepinephrine	0.05 to 2 micrograms/kg per minute IV	Titrate to desired blood pressure
Phenylephrine	0.1 to 0.5 micrograms/kg per minute IV	Bolus: 5 to 20 micrograms/kg Titrate to desired blood pressure
Vasopressin	0.3 to 2 milliunits/kg per minute IV NOTE: Dosing is different for treatment of diabetes insipidus	Limited data in children Not recommended as first-line therapy Titrate to desired blood pressure
Inotropic agents are used for low cardiac output states to improve end organ perfusion. These agents should be titrated to maintain a normal blood pressure for age. Blood pressure alone does not indicate adequate tissue perfusion. Serum biomarkers such as lactate should be followed as inotropic support is titrated.

IV: intravenous.

Reproduced with permission from: Nakagawa, TA. Pediatric donor management guidelines. NATCO, The Organization for Transplant Professionals, 2008. p.5.

Graphic 76583 Version 5.0

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