NUMBER GAME

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  1. CO
    4-8 L /min
  2. CI (Cardiac Index)
    2.5-4.0 L/min/m2
  3. SV
    60-100 ml/beat
  4. SVI (Stroke Volume Index)
    33-47 mL/beat/m2
  5. SVR (Systemic Vascular Resistance)
    800-1200 dynes-sec/cm-5
  6. SVV (Stroke Volume Variation)
    • <15%
    • Reverse of CVP
  7. ScvO2
    >70%
  8. FloTrac Alogrithim
    1) SVI Normal (40-50)
    2) SVI Low (<40)
    3) SVI High (>50)
    • 1) SVI Normal (40-50) - Pressor
    • 2) SVI Low (<40) - Inotrope
    • 3) SVI High (>50) - Diuretic
  9. Propofol Dose
    5-50 mcg/kg/min titrate to effect
  10. Verapamil Dose for AFIB
    5-10 mg IV push over 2 min/ Max 20
  11. Norepinephrine (Levophed)
    0.01-5 microgram/kg/min
  12. Octreotide
    25-50 mcg/hr
  13. Vasopressin (ADH Analog)
    • 0.04 unit/min (septic shock)
    • 0.2-0.4 (variceal bleed)
  14. Fentanyl dose
    • 1-3 mcg/kg (loading dose)
    • 0.7-5 mcg/kg/hr (maintainance)
  15. Lasix Drip
    • 40 mg over 1-2 min (loading)
    • 10-40 mg/hr titrate to effect (max 160 mg/hr)
  16. Insulin drip
    • 0.1 units/kg (loading dose)
    • 0.5-20 units/ hr (weight based, usually 0.1 units/kg/hr and titrate to effect)
  17. Lorazepam (Ativan drip)
    • 1-6 (loading dose)
    • 0.5-15 mg/ hr (usual dose, high dose associated with metabolic acidosis)
  18. Narcan (Naloxone) usual dose
    • 0.4-2 mg IV q2-3min PRN
    • Look for pulmonary edema
  19. Amiodrone drip
    • 150mg in 100ml D5W over 10 min (loading)
    • 1mg/min for 6hours, then 0.5/min for 18 hours
    • Then change to PO
  20. Precedex
    • 1mcg/kg over 10 min (loading dose)
    • 0.2-1.5 mcg/hr (usual dose)
  21. Dobutamine
    • 2.5-20 Mcg/kg/min (usual dose)
    • ------------------
    • 5-15 beta 1 (contractility)
    • >15 (vasodilation, Inc HR)
  22. Dopamine (renal, cardiac, pressor doses)
    • Renal 1-3 mcgm/kg/min
    • Cardiac 3-10 mcgm/kg/min
    • Pressor 10-30 mcgm/kg/min
  23. Diltiazem drip
    • 0.25 mg/kg over 2 min then 0.35 mg/kg over 2 min (load)
    • 5-10 mg/hr (usual)
  24. Vancomycin drug level
    • Peak 20-40, Trough 5-10
    • If peak too high > Decrease amount of each dose
    • Trough too high> Decrease frequency of doses
  25. Gentamicin
    • Peak 6-10 mcg/ml; trough < 1 mcg/ml
    • If peak too high > Decrease amount of each dose
    • Trough too high> Decrease frequency of doses
  26. Cortisol level
    • 3-20 High in AM Low in PM
    • High in stress states 20-40
    • Stim Test: 0.25 ACTH IM, peak cortisol response, 30 to 60 minutes later, should exceed 18 to 20 g/dL (> 497-552 nmol/L).
  27. Risk of HIV and HepB after transfusion
    • HIV 1 in 1-2 million
    • Hep B/C 1 in quater to half million
  28. Estimation of maintainance fluid / hr by weight
    • 4/2/1
    • 4ml for first 10 kg
    • 2 for second 10kg
    • 1ml /kg thereafter
  29. Normal protein/Albumin value
    • protein 6-8.5
    • Albumin 3.5-5.5
  30. Half life
    Albumin
    Transferrin
    Prealbumin
    • Albumin- 20
    • Transferrin- 10 (normal 200–400 mg/dL)
    • Prealbumin- 2 (normal 20-40) <5 severe, 5-10moderate, 10-15 mild depletion
  31. RQ
    • 1- carbohydrate
    • 0.8 protein
    • 0.7 fat
  32. CEA (Carcinoembryonic antigen)
    • 0–2.5 ng/mL
    • Increased in: Colon cancer (72%), lung cancer (76%), pancreatic cancer (91%), stomach cancer (61%), cigarette smokers, benign liver disease (acute 50% and chronic 90%), benign GI disease (peptic ulcer, pancreatitis, colitis). Elevations >20 ng/mL are generally associated with
    • malignancy. For breast cancer recurrence (using 5 ng/mL cutoff), sensitivity 44.4% and specificity 95.5%.
    • Monitoring after surgery: Test is used to follow progression of colon cancer after surgery (elevated CEA levels suggest recurrence 3–6 months before other clinical indicators), although such monitoring
  33. Weaning parameter
    Image Upload 1
  34. Short Gut syndrome
    In adults, 480cm normal small bowel length, <180 increase risk of SGS and <60cm (with colon) are unlikely to achieve independence from parenteral nutrition.
  35. Surgical site Infection:
    Clean
    Clean contaminated
    Contaminated
    Gross Contaminated
    • Clean- 2%
    • Clean contaminated- 3-5%
    • Contaminated 5-10%
    • Gross Contaminated 30%
  36. Central line infection: how many CFU?
    >15 colony forming uits = line infection
  37. SIRS
    • Temp <36C (<96.8F)
    •            >38.3C (100.4F)
    • RR      >20 or PaCO2 <32
    • HR      >90
    • WBC >12k or <4k or >10% band
  38. SEPSIS
    SIRS + long with either a culture-proven or visually identified infection
  39. SEVER SEPSIS
    • Severe sepsis refers to sepsis plus at least one of the following signs of hypoperfusion or organ dysfunction:
    • Areas of mottled skin
    • Capillary refilling requires three seconds or longer
    • Urine output <0.5 mL/kg for at least one hour, or renal replacement therapy
    • Lactate >2 mmol/L
    • Abrupt change in mental status
    • Abnormal electroencephalographic (EEG) findings
    • Platelet count <100,000 platelets/mL
    • Disseminated intravascular coagulation
    • Acute lung injury or acute respiratory distress syndrome (ARDS)
    • Cardiac dysfunction (ie, left ventricular systolic dysfunction), as defined by echocardiography or direct measurement of the cardiac index
  40. Septic shock
    • Septic shock exists if there is severe sepsis plus one or both of the following despite adequate resucitation:
    • MAP  <60 mmHg (or <80 mmHg if the patient has baseline hypertension
    • MAP >60 mmHg requires dopamine >5 mcg/kg per min, norepinephrine <0.25 mcg/kg per min, or epinephrine <0.25 mcg/kg per min .
  41. Adequate fluid resuscitation:
    • 20 to 30 mL/kg of starch, 
    • infusion of 40 to 60 mL/kg of saline solution
    • PCWP 12 to 20 mmHg.
    •  (CVP) of 8 to 12 mmHg
  42. Refractory Septic Shock
    >60 mmHg (or >80 mmHg if the patient has baseline hypertension) requires dopamine >15 mcg/kg per min, norepinephrine >0.25 mcg/kg per min, or epinephrine >0.25 mcg/kg per min despite adequate fluid resuscitation
  43. Epinephrine
    0.1-1 mcg/kg/min (max 5)
  44. Mortality rate of SIRS, sepsis, severe sepsis, and septic shock
    7, 16, 20, and 46 percent, respectively
  45. Indication of thoracotomy based on CTube outpu
    • >1500 after initial insertion
    • >250cc/hr for 3 hours
    • 2500 cc/24hour
    • or bleeding with instablity
Author:
thesaint81
ID:
178340
Card Set:
NUMBER GAME
Updated:
2012-10-27 01:12:19
Tags:
critical care
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ABSITE NUMBER GAME
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