Cardiac Output

[ragland]

Does your unit have any guidelines regarding the following situation:

If a patient's weight changes from one day to the next, eg., by 10 pounds, do you reenter the new weight used to calcualte body surface area when doing cardiac outputs, or do you continue to use the initial weight. I know dry weight would be the ideal weight to use, but some patients are admitted with volume overload already. Any suggestions?

Also, does everyone still use heparinized solution as your flush solution for the Swan Ganz Catheter, or are you using saline? We still use heparinized solution but some hospitals in our area are using saline.

Thnaks in advance for any comments / suggestions. Sandy

[MQ Edna]

Sandy, the unit I presently work in doesn't have any guidelines. However, when I've worked in teaching hospitals, we usually adjusted the drips according to the wt. as well as plugging in the 'new wt.' for the cardiac index. We're using heparinized saline in our flush lines

Aggie

[TanaLisa]

Our unit uses a patients admitting weight for their entire length of stay. A base weight is probably the most accurate with all the diuresing or hydrating we do.

Depending on the patients diagnosis whether the flush solution is heparinized.

[This message has been edited by TanaLisa (edited 11-07-98).]

[barb o]

In our unit, we use "dry" weight for surgical patients in our care. In my understanding, pharmacists don't even all agree on whether to use dry weight or adjusted weight. I know, in many instances, drug therapy is guided by whether or not the desired effect is achieved so weight and BSA are not critical.

We also use heparin flushes for our invasive monitoring devices unless a patient is known to have allergy or heparin-induced antibodies.

[Medwynn]

Our unit uses their dry weight or admit weight. If that isn't available, then we use the bed scale weight. But you're right about fluctuations in weight >10 pounds per day.

We use NS to flush our swan ganz. we use heparin flush syringes for piccs and central lines unless contraindicated.

[MatthewRN]

We use NS for our Swan lines.

[highlandlass1592, BSN, RN]

We use the admission weight and we don't change it. And we use saline due to the increase in people who are becoming HIT positive.

[perkizme]

We don't change weight either. We use NS only - not sure any real benefit to using heparinized (more so than potential risk as mentioned above - i.e. HIT)

[cruisin_woodward]

We use NaCl only. I've never changed the weight, although it's probably a good practice.