If your pt is on dopamine and can't tolerate weaning of it or the vent, how long would they be "allowed" to stay on it? Would the pt eventually develop tolerance?
Feb 2, '07
I don't think there is a tolerance to dopamine as one might develop in heavy narcotic useage. Any pressor usage should be temporary anyway as the underlying reason for needing them should be determined. Length of time on any therapy in the ICU should be outcomes based, and as such, dependant on the individual human receiving them. For example, if you are talking about a 99 year old with end-stage COPD and other co-morbities then I would start asking what our goal is of therapy (can we fix this?). If on the other hand you have a twenty year old with acute lung injury/sepsis,then go all out until you have nothing left.
Feb 2, '07
Pt needs to have a BP. Sometimes, we use a combo of 2 pressors, and then we can wean off the dopa, and then wean off the other one.
I'm not a fan of dopamine, so once we start getting close to the 20mcgs, we start looking towards levo or neo...