Max on Levophed? - page 5
Hi! I'm a fairly new ICU RN and recently had a doctor tell me there is no max on Levophed. Our hospital policy states that the recommended max is 40mcg/min. The doctor refused to give me a second... Read More
Jul 25, '13 by Dodongo, BSNOur hospital policy has us max levo at 1mcg/kg/min - which is obviously silly. Epi is supposed to max at .15 mcg/kg/min but we can go as far above that as we need to go. It doesn't make any sense to have a max for a catecholamine. But we do what we're told. Whatever. So we'll have vaso at .04, levo and neo "maxed" and just keep going up on epi until their fingers fall off. A few weeks ago I had a patient on a rotaprone bed, CVVHD, oscillator vent, inhaled nitric oxide, IABP and maxed on all pressors. Her fingers and toes were black, shriveled and hard. So sad. And gross.
Jul 29, '13 by ICUPrincessNurseLearned yesterday that max on Neo, per our pumps, is 300 mcg/min.
That patient was fine until we decided to put the chest tube in the empyema... By fine of course, I mean on 120 levo, 120 neo, 100% FiO2, 20 PEEP, sats 92%, PaO2 48, HR 137. You know...fine!! Cytokine release kills!
Jun 8, '16 by ohioSICUrn, BSN, RNi know this thread is 3 years old but holy crap! a chest tube on 20 of peep? ouch! lung explosion is all i can picture!!
Sep 12, '16 by jamst149There is a reason there is a max. Law of diminishing returns. At some point you are just delaying the inevitable. It's futile.