Inotropes and pressors
All patients on inotropes should have
- administration via a central line
- invasive BP monitoring
Decision on which inotropes to use, and dosing strategy will always be consultant decision.
The following inotropes are the ones used on PICU
- Dopamine 5 - 20 micrograms/kg/min
- Adrenaline 0.01 - 1 micrograms/kg/min
- Noradrenaline 0.01 - 1 micrograms/kg/min
- Milrinone 0.25 - 0.75 micrograms/kg/min
- Dobutamine 5 - 20 micrograms/kg/min
1 microgram/kg/min = 1000 nanograms/kg/min
Drug |
Dilution |
Dose range |
Rate calculations (typical starting dose in bold |
Milrinone |
Make a standard strength syringe of: 200micrograms in 1ml (10mg in 50ml) in Glucose5%, |
250 - 750 nanogram/Kg/minute (max dose 1microgram/Kg/minute) |
For a 10mg in 50ml syringe 0.075 ml/Kg/hour = 250 nanogram/Kg/minute 0.15 ml/Kg/hour = 500 nanogram/Kg/minute 0.225 ml/Kg/hour =750 nanogram/Kg/minute 0.3 ml/Kg/hour = 1 microgram/Kg/minute |
Adrenaline
|
0.3mg/Kg made up to 50ml in Gluc 5% or NS
|
10nanogram - 1 microgram/Kg/minute |
For a 0.3mg/Kg in 50ml syringe: 1ml/hour = 100nanogram/Kg/min 10ml/hour = 1microgram/Kg/min
|
Noradrenaline |
0.3mg/Kg made up to 50ml in Glucose 5% |
10nanogram - 1 microgram/Kg/minute |
For a 0.3mg/Kg in 50ml syringe: 1ml/hour = 100nanogram/Kg/min 10ml/hour = 1microgram/Kg/min |
Dopamine |
30 mg/kg made up to 50ml in Gluc 5% or NS
|
5 - 20 micrograms/kg/min |
For a 30mg/kg in 50 ml syringe 1ml/hr = 10micrograms/kg/min |
Dobutamine |
30 mg/kg made up to 50ml in Gluc 5% or NS
|
5 - 20 micrograms/kg/min |
For a 30mg/kg in 50 ml syringe 1ml/hr = 10micrograms/kg/min |