nscalern

Same as above

A couple of liter bags of NS with pressure bags and I ask the MD what vasopressor(s) to have in the room. Usually dopamine first and phenylephrine or norepi 2nd.

Open heart, liver transplant, and intubated pts come direct from OR, all others via PACU.

I recently took over an AVR/CABG with a CI of 0.9, SVR of 2700, CVP 5, and on 2mcg/kg/min phenylephrine. Fixed him with 1000ml crystalloid and dobutamine at 5mcg/kg/min. Was able to wean the neo to off. It looks to me your pt was intravascularly dry and needed more fluid with a little inotrope/dilator.

I work in combined SICU/MICU at a VA medical center in Oregon. We frequently have epidurals for post-op (AAA, lung surgery, various abdominal procedures) pain management. Our anesthesiologists usually have them all set up and infusing, but the ICU RNs do this once in awhile, usually for pts who were hypotensive during surgery. We assess dermatomes, respiratory status, and side effects hourly for the first 24 hours and may adjust the infusion within an ordered range. An anesthesiologist or CRNA reassesses the pt after arrival to ICU and at least every daily until the catheter is removed, and only they may give boluses by epidural. I haven't encountered an anesthesia provider who would let anyone else do epidural boluses.

Mycophenolate (MMF)