Initial Experience with Norepinephrine Infusion in Hypotensive Critically III Foals

Seven critically ill foals that continued to be hypotensive despite fluid resuscitation and the infusion of dobutamine and/or dopamine were treated with an infusion of norepinephrine (noradrenaline). The norepinephrine was administered concurrently with dobutamine, and the combination therapy was titrated by use of indirect mean arterial pressure measurements. The highest dose of norepinephrine used was 1.5 mcg/kg/min. In six foals the administration of norepinephrine was associated with an increase in blood pressure. In one foal the mean arterial pressure did not increase in response to the doses of norepinephrine administered. All of the foals experienced an increase in urine output coincident with the start of the norepinephrine infusion. Three of the foal survived to hospital discharge.