Key messages

• In circulatory shock, fluid administration must be optimized before the introduction of any pharmaceutical agent.

• Excessive vasoconstriction can further compromise tissue perfusion and patients must be carefully monitored.

• If hypotension persists despite adequate fluid resuscitation, dopamine administration should be commenced, followed by norepinephrine (noradrenaline) or epinephrine (adrenaline) if required.

• Vasopressors have little positive effect on regional blood flow and the concurrent adminsitration of an inotrope may be considered.

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