NUMBER GAME

4-8 L /min

2.5-4.0 L/min/m2

60-100 ml/beat

33-47 mL/beat/m2

800-1200 dynes-sec/cm-5

• <15%
• Reverse of CVP

>70%

• 1) SVI Normal (40-50) - Pressor
• 2) SVI Low (<40) - Inotrope
• 3) SVI High (>50) - Diuretic

5-50 mcg/kg/min titrate to effect

5-10 mg IV push over 2 min/ Max 20

0.01-5 microgram/kg/min

25-50 mcg/hr

• 0.04 unit/min (septic shock)
• 0.2-0.4 (variceal bleed)

• 1-3 mcg/kg (loading dose)
• 0.7-5 mcg/kg/hr (maintainance)

• 40 mg over 1-2 min (loading)
• 10-40 mg/hr titrate to effect (max 160 mg/hr)

• 0.1 units/kg (loading dose)
• 0.5-20 units/ hr (weight based, usually 0.1 units/kg/hr and titrate to effect)

• 1-6 (loading dose)
• 0.5-15 mg/ hr (usual dose, high dose associated with metabolic acidosis)

• 0.4-2 mg IV q2-3min PRN
• Look for pulmonary edema

• 150mg in 100ml D5W over 10 min (loading)
• 1mg/min for 6hours, then 0.5/min for 18 hours
• Then change to PO

• 1mcg/kg over 10 min (loading dose)
• 0.2-1.5 mcg/hr (usual dose)

• 2.5-20 Mcg/kg/min (usual dose)
• ------------------
• 5-15 beta 1 (contractility)
• >15 (vasodilation, Inc HR)

• Renal 1-3 mcgm/kg/min
• Cardiac 3-10 mcgm/kg/min
• Pressor 10-30 mcgm/kg/min

• 0.25 mg/kg over 2 min then 0.35 mg/kg over 2 min (load)
• 5-10 mg/hr (usual)

• Peak 20-40, Trough 5-10
• If peak too high > Decrease amount of each dose
• Trough too high> Decrease frequency of doses

• Peak 6-10 mcg/ml; trough < 1 mcg/ml
• If peak too high > Decrease amount of each dose
• Trough too high> Decrease frequency of doses

• 3-20 High in AM Low in PM
• High in stress states 20-40
• Stim Test: 0.25 ACTH IM, peak cortisol response, 30 to 60 minutes later, should exceed 18 to 20 g/dL (> 497-552 nmol/L).

• HIV 1 in 1-2 million
• Hep B/C 1 in quater to half million

• 4/2/1
• 4ml for first 10 kg
• 2 for second 10kg
• 1ml /kg thereafter

• protein 6-8.5
• Albumin 3.5-5.5

• Albumin- 20
• Transferrin- 10 (normal 200–400 mg/dL)
• Prealbumin- 2 (normal 20-40) <5 severe, 5-10moderate, 10-15 mild depletion

• 1- carbohydrate
• 0.8 protein
• 0.7 fat

• 0–2.5 ng/mL
• Increased in: Colon cancer (72%), lung cancer (76%), pancreatic cancer (91%), stomach cancer (61%), cigarette smokers, benign liver disease (acute 50% and chronic 90%), benign GI disease (peptic ulcer, pancreatitis, colitis). Elevations >20 ng/mL are generally associated with
• malignancy. For breast cancer recurrence (using 5 ng/mL cutoff), sensitivity 44.4% and specificity 95.5%.
• Monitoring after surgery: Test is used to follow progression of colon cancer after surgery (elevated CEA levels suggest recurrence 3–6 months before other clinical indicators), although such monitoring

In adults, 480cm normal small bowel length, <180 increase risk of SGS and <60cm (with colon) are unlikely to achieve independence from parenteral nutrition.

• Clean- 2%
• Clean contaminated- 3-5%
• Contaminated 5-10%
• Gross Contaminated 30%

>15 colony forming uits = line infection

• Temp <36C (<96.8F)
•            >38.3C (100.4F)
• RR      >20 or PaCO2 <32
• HR      >90
• WBC >12k or <4k or >10% band

SIRS + long with either a culture-proven or visually identified infection

• Severe sepsis refers to sepsis plus at least one of the following signs of hypoperfusion or organ dysfunction:
• Areas of mottled skin
• Capillary refilling requires three seconds or longer
• Urine output <0.5 mL/kg for at least one hour, or renal replacement therapy
• Lactate >2 mmol/L
• Abrupt change in mental status
• Abnormal electroencephalographic (EEG) findings
• Platelet count <100,000 platelets/mL
• Disseminated intravascular coagulation
• Acute lung injury or acute respiratory distress syndrome (ARDS)
• Cardiac dysfunction (ie, left ventricular systolic dysfunction), as defined by echocardiography or direct measurement of the cardiac index

• Septic shock exists if there is severe sepsis plus one or both of the following despite adequate resucitation:
• MAP  <60 mmHg (or <80 mmHg if the patient has baseline hypertension
• MAP >60 mmHg requires dopamine >5 mcg/kg per min, norepinephrine <0.25 mcg/kg per min, or epinephrine <0.25 mcg/kg per min .

• 20 to 30 mL/kg of starch, 
• infusion of 40 to 60 mL/kg of saline solution
• PCWP 12 to 20 mmHg.
•  (CVP) of 8 to 12 mmHg

>60 mmHg (or >80 mmHg if the patient has baseline hypertension) requires dopamine >15 mcg/kg per min, norepinephrine >0.25 mcg/kg per min, or epinephrine >0.25 mcg/kg per min despite adequate fluid resuscitation

0.1-1 mcg/kg/min (max 5)

7, 16, 20, and 46 percent, respectively

• >1500 after initial insertion
• >250cc/hr for 3 hours
• 2500 cc/24hour
• or bleeding with instablity