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Vasoactive-Inotropic Score (VIS) Calculator

Enter the vasopressor and inotrope doses to get the VIS.

How it is calculated

The tool adds the doses of seven drugs, each multiplied by a fixed weight: VIS = dopamine + dobutamine + 100 × epinephrine + 100 × norepinephrine + 10 × milrinone + 10,000 × vasopressin + 50 × phenylephrine. Dopamine, dobutamine, epinephrine, norepinephrine, milrinone and phenylephrine are entered in mcg/kg/min, and vasopressin in units/kg/min. Fields left blank count as 0, but at least one dose must be entered, and no dose may be negative. The weights are what make the doses comparable: vasopressin is so potent per unit that it is multiplied by 10,000. Note that the tool includes phenylephrine (weight 50), which is not part of some published versions of the score. The result is rounded to two decimals and is a unitless number.

Worked example

A child receives dopamine 5, epinephrine 0.05 and milrinone 0.5 mcg/kg/min, plus vasopressin 0.0003 units/kg/min. Dopamine contributes 5. Epinephrine: 100 × 0.05 = 5. Milrinone: 10 × 0.5 = 5. Vasopressin: 10,000 × 0.0003 = 3. The sum is 5 + 5 + 5 + 3 = 18.00. Without the vasopressin, the score would be 15, which shows how a very small vasopressin dose still adds noticeably to the total.

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Common mistakes

  • Entering vasopressin in units/kg/hour or mU/kg/min rather than units/kg/min. With the weight of 10,000, a wrong unit changes the score by a factor of 60 or 1,000.
  • Mixing minutes and hours for the other drugs. All the catecholamine doses must be per minute.
  • Entering the dose per patient instead of per kilogram. The score assumes doses already divided by body weight.
  • Comparing scores from different formulas. This version adds phenylephrine, so a value calculated elsewhere without it may not match.
  • Using the number as a treatment instruction. It describes the intensity of support after the fact and does not tell you which dose to give.

Sources

About this calculator

The Vasoactive-Inotropic Score (VIS) is a weighted-sum index — VIS = dopamine + dobutamine dose (mcg/kg/min) + 100×epinephrine + 10×milrinone + 10,000×vasopressin (units/kg/min) + 100×norepinephrine + 50×phenylephrine (mcg/kg/min) — that turns a cocktail of different cardiovascular support drugs, each dosed on a different scale, into one comparable number representing how much pharmacologic support a patient's circulation needs.

It was developed and is used almost exclusively in paediatric cardiac intensive care, particularly after congenital heart surgery, where a higher peak VIS in the first 24-48 hours is a well-validated predictor of prolonged ventilation, longer ICU stay and mortality, helping intensivists track a child's trajectory and decide when to escalate or wean support.

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