Flashcards in critical care Deck (26):
What is Levophed?
SIR criteria (need 2)
WBC > 12 or 20, HR > 90, temp > 38 or 10% bands
Disruption of CNS -> unopposed vagal tone, vasodilation. Low BP and bradycardia. Tx fluids, pressors, atropine and/or pacemaker for brady
Tx of cardiogenic shock, left-sided HF
Diuretics, nitrates, pressors (dopamine medium dose, dobutamine, amrinone), intra-aortic balloon pump can be used
Tx of cardiogenic shock, right-sided HF
Give fluids to maintain preload
What is a normal SVR index?
700 to 1600 (1100) dynes*sec*cm^-5
What is a normal PCWP?
4-12 (9) mm Hg
What is a normal RA pressure?
1-5 (3) mm Hg
What is a normal PVR?
20-130 (70) dynes*sec*cm^-5
What is normal RV pressure?
25/9 mm Hg
What is normal cardiac index?
2.5 to 3.5
What is normal PASP?
15-30 / 6-12 (10-18) mm Hg
Strong beta1 (inotrope, chronotrope), mild beta 2 (vasodilate). Used in cardiogenic shock.
Strong beta1 and beta 2. used in cardiogenic shock with bradycardia
Not a pressor but used in ICU often. Phosphodiesterase inhibitor with ionotropic and vasodilator effects. Used in HF, cardiogenic shock.
Low dose stim DA receptors and mildly beta 1 (used in renal failure, medium dose stim DA and moderately beta1 and mild alpha 1 (used in cardiogenic shock), high dose stim DA and beta1 and strongly alpha1 (used in cardiogenic or septic shock)
Strongly stim alpha1 and beta1. Used in septic shock.
Strongly stimulates beta1, alpha1, and moderate beta2. Used in anaphylaxis, sepsis, cardiopulmonary arrest.
Alpha1 only, used in septic shock, neurogenic shock, anesthesia-induced hypotension
Types of MV: pressure support
There is an initial "boost" of pressure, triggered by the patient's own breath, which helps overcome the resistance created by the endotracheal tube. This mode can be used on its own or in concert with IMV mode. Important mode for weaning.
Types of MV: assist-control (AC)
Set tidal volume is given a set number of times per minute. If the patient initiates a breath, the ventilator responds by giving the preset tidal volume.
Types of MV: intermittent mandatory ventilation (IMV)
When pt initiates a breath, the ventilator gives boost of pressure support, but tidal volume is det by patient's effort. If pt does not initiate breath, there is back up to automatically give set # of breaths per minute (like AC).
Types of MV: CPAP
Continuous positive airway pressure, regardless of breathing cycle. Patient must breath on own
Types of MV: PEEP
positive end-expiratory airway pressure. Usu set at 5-20 mm Hg
Tidal volume should be set at what?