Levophed vs. Neo

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Hey all - wondering about how many of your facilities use levophed as 1st line defense for hypotension versus neosynephrine. I'm actually wondering why my MICU docs don't use neo more. I know that in general, levo is a go-to 1st ... but when you think of your septic patient who is already tachycardic from their fever, and hypotensive....why not go with the neo that will help increase the BP and decrease the HR?

thoughts/feelings? discuss :)

Specializes in Anesthesia.
Apparently you cannot read. I even posted the web link. Levo requires a central line. Also where do you people work at that you give vasoconstictors without central lines? In the er while waiting for a line maybe, but not on a unit. I have not worked in a unit where we put any vasoconstricter without a central line for at least five years. Think about it. If its not going in (extravasating) whats it doing for you patients blood pressure. That sad nonsense about your wife going to die but we can't use a vasoconstrictor peripherally is nonsense. The first thing your going to do is a fluid challenge and while that is going on you get a central line placed.

I have given Levophed through a peripheral line many, many, many times. There has only been one incidence where a line infiltrated, Regitine was given, and there was no necrosis, at all! In a perfect world all pts receiving pressors would have a central line for infusion. This isn't a perfect world and not all pts have central lines.

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