11:709:364 Lecture Notes - Lecture 12: Pulmonary Artery Catheter, Isoprenaline, Dobutamine
25 Feb 2020
School
Department
Course
Professor
Document Summary
Malnutrition was independently associated with poorer clinical outcomes such as: Incidence of infection: risk of hospital mortality. Can help decide if a patient is ready for nutrition support. Assesses shock states, adequacy of oxygen saturation, and adequacy of cardiac and vascular function. Vasopressors: cause vasoconstriction to increase the mean arterial pressure (map) Medications that have both vasoconstriction and inotropic effects: norepinephrine (levophed, dopamine (inotropin, dobutamine (dobutrex, vasopressin. Hemodynamic instability: en should be withheld until the patient is hemodynamically stable, low flow state . Initiation/reinitiation of en may be considered with caution in patients undergoing withdrawal of vasopressor support. Any signs of intolerance should be evaluated as possible early signs of gut ischemia: abdominal distention. Increasing nasogastric tube output or gastric residual volumes: decreased passage of stool and flatus, hypoactive bowel sounds. Body composition modalities in the icu: bioelectric impedance (bia) Generally higher than energy requirements: may lead to use of modular protein supplements.
