Quote from RNKylie
I guess I am trying to understand the equivalence of how much Dopamine in MCG related to mls.
For instance, curious to know how many mcg can be potent or dangerous?
I dont know how else to explain my confusion
Depends on the situation, and the weight of the person. The first thing to consider, and this isn't considered widely enough, is that before moving to a pressor, volume replacement is the first consideration. It does no positive good to squeeze down on volume that isn't there.
When it comes to pressure rescue, barring contraindications (left sided heart failure, cardiogenic shock), and many times, even considering them, the key is: volume volume volume.
Generally, 10mcg/kg/min would be the highest normal dose for a pt without calling MD. At that point, we normally begin to consider adding something else for pressure support.
So, for a 100kg (~220 lb) person and using my math above:
26.6/100 = .266 or .27 (I normally round here).
If you want to know the mls/hr rate for 10mcg that would be 10/.27 = 37 ml/hr. If a person is larger, that rate would be higher, if a person weighs less, that number would be smaller.
Now, in a dire situation, life or death correction needed now, we normally go up as high as 20mcg/kg/min or about 70ml hr for this 220 lb person. Any more than that is typically, based on my anecdotal experience, refractory - there is no more benefit. As far as the dose being potent or dangerous, if we are playing with doses this high on someone, the situation is ALREADY dire, regardless how much dopamine is running. I've seen codes where it is run wide open. Again, my experience is that at some point, the system becomes refractory to responding to high high doses, and the drug would need to be used in conjunction with other treatments.
Now, if you want to know the same thing for a 110 lb person, the kgs would be half and I could do the math, but it would be half: ~19ml/hr = 10mcg/kg/min and about 37ml/hr = a very high dose: 20mcg/kg/min.
I will say this, in my neck of the woods, dopamine was the 'gold standard' for years. But, levophed has made a comeback. Levophed is not just 'leave 'em dead' (used last ditch) anymore.