Scribd
Upload
23 views3 pages

Hemant

Uploaded by

sipubaliarsingh1999
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
23 views3 pages

Hemant

Uploaded by

sipubaliarsingh1999
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
You are on page 1/ 3

Vasopressors guideline in IGOT ICU

All patients with hypotension


After 20ml/ kg fluid NS or RL bolus administration over 1 to 2 hours
Measure lactate >2mmol
And MAP less than 55 mmHg
Check for Cardiac status, IVC and B-lines in Lung
Start Moradrenaline preferable through central line, in emergency
Can give through peripheral line
Single strength – 8ml + 5% dextrose or NS 42 ml total = 50ml through infusion pump
This is 80 microgram/ ml
Contains 4mg Noradrenaline base
Double strength – 16ml + 5% dextrose or NS 34 ml total = 50ml through
Infusion pump
This is 160 microgram/ ml
Contains 8mg Noradrenaline / kg/min
If the dose reaches 0.2 ug/ kg/min refractory shock
High mortality
If the dose reaches 0.2 ug/kg – severe shock
Add Vasopressin – Dose 0.001 to 0.003 units/kg
Not responding give –Hudrocortisone 100mg stat
Vasopressin
Infusion for sepsis 0.01 –
Usually started at 3 ml/hour,………………………….max 4 to 5 ml/hour
20units/ml, add 2.5ml to 47.5 ml NS
1ml = 1unit
Start at 1 ml can titrate 4 to 5ml/ hr

Dobutamine – SINGLE strength -250 mg in 50 ml (5 mg in 1 ml)

Dosage 60kg 70kg 80kg 100kg


Ug/kg/min 3l/hr Ml/hr Ml/hr Ml/hr
5 microgram/kg/min 3.6 4.2 4.8 6
10microgram/kg/ 7.2 8.4 9.6 12
min
15microgram/kg/ 10.8 12.6 14.4 18
min
20microgram/kg/ 14.4 16.8 19.2 24
min
g/1
mEq/1 Dextrose
Intravenous fluids MOsm/1a Na - C1 K Ca Mg Lactate (g/1)
5% Dextrose in water (D5W) 278 50
5% Dextrose in 0.45% NaCl 405 77 77 50
5% Dextrose in 0.9% NaCl 561 154 154 50
5% Dextrose in Ringer’s solution 525 130 109 4 3 50
Ringer’s solution 309 147 156 4 4 -45
Lactated Ringer’s solution 275 130 109 4 3 28
5% Dextrose in Lactated 525 130 109 4 3 28 50
Ringer’s solution
Plasmaytch 298 140 98 5 3
0.45 % NaCl 154 77 77
0.9% NaCl 308 154 154
3.0% Saline 1026 513 513
5.0% Saline 1710 855 855
7.5% Saline 2566 1283 1283
20% Mannitol 1098
a osmolarity = calculated value (osm/1 – mg ÷ molecular weigh X 10 X valene)
b Acctate 27 mEq/1 and gluconate 23 mEq/1.

You might also like