INDICATION OF PROCEDURE

Adult or pediatric patient who fail to maintain a systolic blood pressure greater than 90 mmHg due to:

• Cardiogenic shock associated with hypotension.
• Hypovolemic shock with sufficient fluid resuscitation.
• Septic shock.
• Anaphylactic shock.

CONTRAINDICATION

• Hypovolemic shock where complete fluid resuscitation has not occurred.
• Uncorrected tachydysrhythmias or v-fib.

SIDE EFFECTS

• Tachydysrhythmias.
• Ectopy.
• Headachea.
• Angina.
• Nausea / Vomiting.

PROCEDURE

• Adult patient weight >40 kg:-
  • Inject Dopamine 400 mg into 250 ml normal saline with microdrip set (60 gtts/cc).
  • Infuse at 10 mcg/kg/min to achieve a systolic BP>90 mmhg.
  • If refractory, increase the infusion rate to 20mcg/kg/min.
  • Do not exceed maximum infusion rate of 20 mcg/kg/min.
  • Stop infusion if tachydysrthmias, hypertension, anginal pain, nausea or vomiting develops.

  Weight in KG	10 mcg/kg/min	20 mcg/kg/min
  45	17 Drops	34 Drops
  55	21 Drops	41 Drops
  65	24 Drops	49 Drops
  75	28 Drops	56 Drops
  85	32 Drops	64 Drops
  95	36 Drops	71 Drops
  105	39 Drops	79 Drops
  115	43 Drops	86 Drops
  125	47 Drops	94 Drops
  135	51 Drops	101 Drops
  145	54 Drops	109 Drops
  155	58 Drops	116 Drops

• Pediatric patient weight 5-20 kg:
  • Inject 100 mg of Dopamine into 250 ml normal saline with microdrip set (60 gtts/cc).
  • Infuse at 10 mcg/kg/min to achieve a systolic BP > 90 mmhg.
  • If refractory, increase infusion to 20 mcg/kg/min.
  • Do not exceed maximum infusion rate of 20 mcg/kg/min.
  • Stop infusion if tachydysrthmias, hypertension, nausea or vomiting develops.

  Weight in KG	10 mcg/kg/min	20 mcg/kg/min
  5	8 Drops	15 Drops
  10	15 Drops	30 Drops
  15	23 Drops	45 Drops
  20	30 Drops	60 Drops

• Pediatric patient weight 25-40 kg:
  • Inject 200 mg of Dopamine into 250 ml of normal saline with microdrip set (60 gtts/cc).
  • Infuse at 10 mcg/kg/min to achieve a systolic BP >90mmhg.
  • If refractory, increase infusion to 20 mcg/kg/min.
  • Do not exceed maximum infusion rate of 20 mcg/kg/min.
  • Stop infusion if tachydysrthmias, hypertension, nausea or vomiting develops.

  Weight in KG	10 mcg/kg/min	20 mcg/kg/min
  25	19 Drops	38 Drops
  30	23 Drops	45 Drops
  35	27 Drops	53 Drops
  40	30 Drops	60 Drops