Midodrine — why don't you just work better?

Successful identification and characterisation of a titratable and safe oral agent that consistently increases blood pressure carries a great deal of appeal and the promise of negating physician and patient frustration and morbidity in a significant tranche of intensive care unit (ICU) patients. Universally, ICUs often house patients with mild hypotension rate limiting them from going to the ward, be that in the postoperative period, during recovery from critical illness, or in patients with decompensation of a chronic condition where augmented blood pressure for a period may be beneficial. These groups of patients are not traditionally “shocked” and perhaps do not require the full gamut of intensive management that we are used to providing to critically ill patients but are unable to be cared for on the ward. An oral vasopressor could provide this treatment and conceivably relieve some of the capacity constraints that units are facing.