Quote from asoldierswife05
I am just a new grad in ICU and I don't find this order very odd at all. Am I missing something here? If so, can someone clarify....
The 'odd' part of this order is that according to the OP, the MD left an open-ended 'titrate'. Which, as you know, is not done if you're at the ordered dose. (yes you many times titrate up, but once there the 'titrate' aspect of the order is moot).
Or, the order WAS written to titrate to target, but the OP just didnt realize it...Or,the OP wasnt sure how to titrate up (or what to watch)...Or...i misunderstood the OP?
*And usually when 'titrating' dobutamine, it's not typically done by watching its 'effectiveness'(meaning, is the UO better?, CVP better?, PAP, etc...) but rather it's 'titrated up' because it's many times not tolerated by certain patients and/or at higher doses. This becomes more obvious when you consider the volume of dobutamine drips started on tele floors without the capacity to monitor CVP's/PAP's, etc.)*
Sure, if the MD thinks a higher dose would make a difference he'd then (the next day?) order a higher dose...(and probably a 'titrate' to target type as well)
<i think the OP may be confusing 'titrate' to mean "go up until effective", when it actually means "go up to 10 mcg/kg/min SLOWLY as tolerated".... I think.>