Diprivan question

KR · Mar 24, 2003

Hi all! While it is nurses judgement in the MICU where I work at on how high we go up on the diprovan, our intensivists generally do not like us going above the 75-80 mcg/kg/min range. They have showed us the literature that prolonged high does of diprovan can cause V-tach. Just a point to ponder.

Patricia116 · Apr 22, 2003

Originally posted by Estella
Hi!
We have a nutritionist and pharmacist working together on a daily basis to keep the lipid levels r/t diprivan and TPN usage. When tube feeds start, they reevaluate the lipids there, too, just to be sure the pt isn't getting way too much fat. (We get a lot of gastric bypass pts. The last thing they need is a large fat intake. Their TPN is usually without lipids.)

Another point to remember when using Diprivan with an obese patient, to avoid excessive dosing, the patient's ideal weight should be used to adjust dosage according to the manufacturer of Propofol.

jadednurse · Apr 22, 2003

Originally posted by New CCU RN
well to repost on this too.... our docs now are trying to stear away from sedation while pts are intubated bc of some study?? anyone heard of it that i guess says that nonsedated pts are extubated quicker than sedated ones...

i havent gotten my hands on this study yet...

i just know it is making for wild times in our ccu (not to mention pts in a lot of pain)

I cringe when I hear things like this. I wonder how many of these docs have ever been intubated!

Good thread, informative posts. I've found that the dosing of Diprivan really varies w/ the climate you work in, and the knowledge base of the doctors who are writing for it.

Getting back to your original post...what the heck good is it to continue any sedation if IT"S NOT WORKING? First, they need to make sure the patient is being treated for pain (as one post pointed out, Dirprivan is used for sedation, NOT analgesia!). Second, they may need to use a combination of drugs or find a different one entirely. Diprivan is costly, especially if it's not working!

New CCU RN · Apr 22, 2003

Well, the rationale behind the study was that those patients that were heavily sedated had a longer time to be extubated. While I agree that you need to treat pain, I can understand keeping a patient awake but treating the pain, rather than completely snowed. Vent acquired pneumonia, sepsis, and ARDS secondary to prolonged intubation times are alot worse.

jeannet83 · Apr 23, 2003

In our ED and trauma bay, we use propofol gtts as well for sedation. I find the healthy young guys really tear it up fast more so than the elderly. We also use small boluses of Propofol for conscious sedation of awake and non-intubated patients who need fractures aligned or dislocations put back in place. Works like a charm!

We are not allowed to use Droperidol anymore secondary to its history of cardiac effects. Are other people still using Droperidol?

Jeanne :)

RNCENCCRNNREMTP · Apr 25, 2003

Originally posted by jeannet83
We are not allowed to use Droperidol anymore secondary to its history of cardiac effects. Are other people still using Droperidol?

Jeanne :)

Ever since droperidol got "black labeled" for its association with Torsades we have not used 1 drop!!!!

RNCENCCRNNREMTP · Apr 25, 2003

Originally posted by jeannet83
We are not allowed to use Droperidol anymore secondary to its history of cardiac effects. Are other people still using Droperidol?

Jeanne :)

Ever since droperidol got "black labeled" for its association with Torsades we have not used 1 drop!!!!

jlc · May 3, 2003

At my hospital we use diprivan up to 100/mcg/kg with no problem. Our orders are to titrate for effect. JJ