norepinephrine infusion rate

[nagoyankitty]

I've been searching on Pubmed with no luck...
Some institutions have set NE max infusion rate as 60 mcg/min. Is there a study that validates this somehow? The hospital I am currently at has max set at 46 mcg/min, so I just want to know if there's a reference that says 60 mcg/min has been used successfully.

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[VCU07]

I've been searching on Pubmed with no luck...
Some institutions have set NE max infusion rate as 60 mcg/min. Is there a study that validates this somehow? The hospital I am currently at has max set at 46 mcg/min, so I just want to know if there's a reference that says 60 mcg/min has been used successfully.

We use 30 as a max at our institution. What this really means is that we add on vasopressin once reaching that limit. Of course, all limits go out the window in certain situations. We do it primarily to reduce SE from higher dose NE use.

 

[Dred Pirate]

I've been searching on Pubmed with no luck...
Some institutions have set NE max infusion rate as 60 mcg/min. Is there a study that validates this somehow? The hospital I am currently at has max set at 46 mcg/min, so I just want to know if there's a reference that says 60 mcg/min has been used successfully.

at some point you reach the point of diminishing returns, there are no true maximums on pressers, but if you are over 10 - you need to add a pressor - usually vasopressin. I would never run levophed at 40-60 alone?!?!? if you are "maxed" out of all other options, ya, what can it hurt if that is the only thing keeping them alive

 

[VCU07]

at some point you reach the point of diminishing returns, there are no true maximums on pressers, but if you are over 10 - you need to add a pressor - usually vasopressin. I would never run levophed at 40-60 alone?!?!? if you are "maxed" out of all other options, ya, what can it hurt if that is the only thing keeping them alive

10 is a pretty low cut off for adding another pressor.

 

[Dred Pirate]

10 is a pretty low cut off for adding another pressor.

depends on the situation, often I am in the ED - they only have a peripheral line, so yes, in that case, I would rather add vassopressin to avoid the peripheal line clamping down