Changing BSA daily?? I don't think so...

Specialties CCU

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Specializes in CVICU, CCU, MICU, SICU, Transplant.

A while back I posted a thread regarding changing infusion rates of vasoactive meds based on daily weights. Last night I had a similar issue come up regarding changing the weight in our continuous cardiac output monitor on a daily basis to update the BSA (for the cardiac index and such).

A fellow nurse and I got into a strong debate on this matter. I definately do NOT feel it is good practice to change the data. She thinks it should be changed daily. It's my opinion that the BSA should be left alone so that one can see consistent trends and get accurate hemodynamic values. Also, the fluid that is 3rd spaced in our all-too-often vol overloaded pts doesn't have anything to do with the stroke volumes and cardiac outputs. Basically, she thinks I'm either crazy, or stupid, or both - but it makes perfect sense to me.

Any comments? Anyone know of any references or journals that can back me up?

Jim

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Specializes in Critical Care, Cardiothoracics, VADs.

I agree with you. How are you to know the trend of data if the constant is not constant? I wonder if the manufacturer manual has comment on this?

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Specializes in CVICU, CCU, MICU, SICU, Transplant.

Thanks for the reply, Augigi. I emailed the manufacturer, and while he wasn't of liberty to give official advice on patient monitoring, he said that the "norm" is to keep the weight/height the same so one can view the trends.

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Specializes in Critical Care, Cardiothoracics, VADs.

Great - now we both know! I hope you're printing out that email for your colleague...

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Specializes in Cardiology.

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Specializes in CVICU-ICU.

I do believe that most recommendations for drugs call for the use of dry weight. I know anywhere I've ever worked we always used the patients admission weight and kept using that weight throughout when figuring dosages for medications.

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Specializes in Critical Care, Cardiothoracics, VADs.

Similar issue, but the OP was talking about calculating cardiac indices based on BSA, not meds.

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I dont change the weight daily since what you are using is more of the patients dry weight.

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Specializes in ICU, Education.

The weight should not be changed. Everything is based on dry weight. We don't treat water. However, it's not worth arguing over. There will always be those who think they know it all. Just bring in data to back up your stance and post it all over the unit :-)

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