What must be restored before initiating the use of pressors?

Restoration of intravascular volume is critical before initiating the use of pressors. Pressors, or vasopressors, are medications used to elevate blood pressure in cases of hypotension, often due to shock or severe blood loss. However, the efficacy of these medications depends significantly on having an adequate intravascular volume.

When there is low intravascular volume, such as in cases of dehydration or hemorrhage, the circulation system lacks the necessary blood volume to effectively maintain organ perfusion and blood pressure, even with pressor support. Administering vasopressors without first addressing volume deficits can lead to tissue ischemia, excessive afterload, and increased myocardial oxygen demand, potentially worsening the patient’s condition.

Replenishing intravascular volume typically involves fluid resuscitation with crystalloids or colloids, and only after this volume is adequately restored should vasopressors be considered to further support blood pressure and improve organ perfusion.