Post resuscitation, a 52-year-old male has carotid pulses and weak radial pulses, crackles bilaterally, BP 70/42, P 84. Which infusion should be administered?

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After resuscitation, the goal is to support perfusion by improving cardiac output and raising mean arterial pressure without oversuppressing heart function or worsening pulmonary edema. A moderate-dose dopamine infusion (about 5 mcg/kg/min) fits this need because it provides beta-1–driven inotropy and chronotropy to boost cardiac output, while also producing some alpha-adrenergic vasoconstriction to raise systemic vascular resistance and blood pressure. This helps improve perfusion to vital organs in a hypotensive patient with signs of edema, without the marked vasoconstriction or tachyarrhythmias that higher doses of other agents might provoke.

Epinephrine would raise heart rate and myocardial oxygen demand and could worsen ischemia or arrhythmias. Norepinephrine strongly elevates SVR and afterload, which can reduce cardiac output in a patient with poor CO. Phenylephrine is a pure vasoconstrictor that increases afterload and can decrease cardiac output and worsen perfusion in a low-output state. Dopamine at the moderate dose provides a balance: supports CO while raising BP, addressing the immediate post-ROSC hypotension.