1. Will someone give me the definition of "titration"? and use it in the context of clinical setting.
  2. 6 Comments

  3. by   NurseDennie
    Well, the definition is regarding using the smallest amount of a reagent of known concentration to cause whatever the reaction you're looking for, with a known volume of the test solution. It seems to me in chem we also sometimes "titrated OUT" something, where we increased the concentration until it was no longer soluble and the stuff we were dissolving started to just fall to the bottom of the solution. Am I mis-remembering?

    In a clinical setting, it's used as in an order from a doc to titrate a certain med to a certain outcome. Often titrate drips to a desired BP, or titrate heparin to a desired PT.


  4. by   ohbet
    Thank you Dennie,
    If the Doc. gives the order to titrate a med to a certain out come,doesnt that just mean to adjust it slowly until the outcome is achieved? For instance "titrate the o2 until the sats. are 96%" would mean slowly adjust the amount of o2 until 96% is achieved.
    Or is there more to it?
  5. by   LilgirlRN
    The medication that comes to mind using the word titration, well there are 2..NTG and dopamine. NTG we titrate to pain and blood pressure, meaning that if they still have pain and they're BP can tolerate the lowering effect of NTG it's OK to bump up the dose. With dopamine you titrate to increase the BP, but you have to watch how many mcg/kg/min you are giving or you can eat the kidneys up.
  6. by   Zee_RN
    Yes, Ohbet, Doc's frequently write "titrate 02 to maintain sat of of >= 93%." And what you said is exactly what they mean. Adjust the O2 delivery level until you get what you want.

    In critical care units, IV medications are also titrated. Vasoactive and anti-arrhythmic medications such as dopamine, dobutamine, nitroglycerin, and levophed. Heparin is also an IV medication that is titrated; at our hospital, its titration is governed by a protocol (based on PTT results). Nitroglycerin is commonly written to be administered "titrate for pain control" for chest pain patients. The nurse will increase the amount of IV nitroglycerin given until the patient says his/her pain is gone. Dopamine may be written to "titrate to maintain a systolic blood pressure of 90." Hospital policy will dictate what your maximum dose of certain medications is. Experience is what teaches you how much to increase and when! It was my biggest challenge when I was a new nurse in ICU--do I increase it now?! How much?! With experience, you learn.

    In our hospital, only the ICU is allowed to titrate vasoactive medications. All floors titrate (based on protocol) Heparin. Hope this helps!
  7. by   ohbet
    Thanks alot guys,that helps.
  8. by   RNed
    I would also add that in most cases the order to titrate is an order to increase to desired effect. Although titrate can mean increase and decrease. Another order is to "wean" to desired effect. This is the opposite. Example, "wean dopamine to maintain B/P systolic pressure > 100.

    Sorry, just trying to cover all the bases. My kids hate it when I answer like that. They say, "ha, I just wanted the answer, I didn't ask that and I don't want a medical lecture". Just the nurse in me, poor kids having to be raised by nurses.