children with fluid-refractory, catecholamine-resistant septic shock However, in a multicenter trial of 65 children with vasodilatory shock, low-dose vasopressin did not decrease the time to hemodynamic stability off of vasoactive agents versus placebo (49.7 vs 47.1 hours) and there was a concerning trend toward increased mortality in the vasopressin group (30% vs 16%, p = 0.24) TABLE 10.4 VASOACTIVE AGENTS For patients with “cold” shock, priority should be given to improving cardiac contractility with inotropes First-line therapy with epinephrine is recommended Addition of norepinephrine or dopamine may be considered for ongoing hypotension despite titration of epinephrine Once the patient is transferred to the ICU, ScvO2 is often monitored If ScvO2 remains