Adenosine Challenge Test in Cath Lab

[cathnurs]

I am looking for a protocol, policy or procedure for mixing and administering an infusion of Adenosine to r/o pulmonary hypertension during a diagnostic right heart cath. Any help would be greatly appreciated!!!!!:redbeathe

[dianah, ASN]

Have never used it for that, we infuse it ("chemical stress test") for limited- or non-ambulatory stress tests, in conjunction with nuclear imaging.

Have heard of doing a Flolan challenge (with PA cath in position, and pt monitored in the ICU) . ..

Will need to do a search . . .

[dianah, ASN]

there are many articles about using adenosine for newborns/premies/peds with pph, though not as many articles about adult pulm htn.

i did find a few:

http://www.circ.ahajournals.org/cgi/content/abstract/86/3/896

http://ats.ctsnetjournals.org/cgi/content/abstract/61/4/1118

http://jap.physiology.org/cgi/content/abstract/76/2/724

http://ccforum.com/content/2/s1/p117

hope those are helpful (i used the following search words: adenosine infusion pulmonary hypertension. you might narrow the search even more by adding "cath lab" to the search words).

good luck! -- d

[Guest27531]

I hope you received the answer you were looking for, as your question was posted a long time ago but I'll provide this information for anyone who is looking for the info in the future. Our cath lab uses the following dosing:

Full strength adenosine 3000mcg/ml to be infused in progressive stages (as ordered verbally by the physician doing the procedure): 50mcg/kg/min, 70mcg/kg/min, 90mcg, 110mcg/kg/min, 110mcg/kg/min, 130mcg/kg/min, 150mcg/kg/min, 170mcg/kg/min, 190mcg/kg/min (max 200mcg/kg/min). The formula to calculate the pump rate:

Dose (mcg/kg/min) x weight in kg x 60 (min/hr)

____________________________________

concentration adenosine (mcg/ml)

For example:

50 x 80 x 60

___________

3000/1

Calculated = 50 ml/hr