Cognitive Approach to Vasopressor Non-Responsiveness

When a patient on vasopressors fails to respond adequately, the initial instinct is often to add a second vasopressor. However, it's crucial to pause and investigate the underlying reasons for the lack of response. Factors such as acidosis, which can significantly inhibit the effectiveness of vasopressors, should be considered; simple solutions like administering bicarbonate are insufficient without managing the root cause of the acidosis. An organized approach that includes recognizing multifactorial pathologies rather than adhering strictly to Occam's razor can lead to better patient outcomes.