Norepinephrine CRI
Posted: Sunday, October 10th, 2021 | Updated: Monday, January 16th, 2023
Posted: Sunday, October 10th, 2021 | Updated: Monday, January 16th, 2023
Doctor's Order:
Start a Norepinephrine CRI at 0.2 mcg/kg/min
Patient Weight:
10 kg
Standard Dilution Protocol (Varies By Hospital):
Dilute Norepinephrine with D5W where 0.1 mcg/kg/min = 1 ml/hr and create a 12 hour CRI at that rate
Norepinephrine Concentration:
1 mg/ml
Convert the Norepinephrine from mg to mcg:
(1 mg/ml) x (1,000 mcg/mg) = 1,000 mcg/ml concentration of Norepinephrine
Complete the Math:
(0.1 mcg/kg/min) x (10 kg) = 1 mcg/min of Norepinephrine
(1 mcg/min) x (60 min/hr) = 60 mcg/hr of Norepinephrine
(60 mcg/hr) / (1,000 mcg/ml) = 0.06 ml/hr of Norepinephrine
(0.06 ml/hr) x (12 hr) = 0.72 ml Norepinephrine
(12 ml Total Fluid Volume) - (0.72 ml Norepinephrine) = 11.28 ml D5W
The Result:
You will need 0.72 ml of Norepinephrine to mix with 11.28 ml of D5W. This will result in 0.1 mcg/kg/min = 1 ml/hr. To run the Norepinephrine CRI at 0.2 mcg/kg/min, increase the fluid rate of your CRI to 2 ml/hr
*Note Per Plumb's as of 01/16/23: "Norepinephrine is incompatible with aminophylline, sodium bicarbonate, ranitidine, or pantoprazole. Administer whole blood or plasma separately (via a Ytube and individual containers if given simultaneously). Dilute norepinephrine in dextrose 5% or dextrose 5% with 0.9% sodium chloride. Administration in 0.9% sodium chloride alone is not recommended as significant loss of potency can occur due to oxidation."
Start a Norepinephrine CRI at 0.2 mcg/kg/min
Patient Weight:
10 kg
Standard Dilution Protocol (Varies By Hospital):
Dilute Norepinephrine with D5W where 0.1 mcg/kg/min = 1 ml/hr and create a 12 hour CRI at that rate
Norepinephrine Concentration:
1 mg/ml
Convert the Norepinephrine from mg to mcg:
(1 mg/ml) x (1,000 mcg/mg) = 1,000 mcg/ml concentration of Norepinephrine
Complete the Math:
(0.1 mcg/kg/min) x (10 kg) = 1 mcg/min of Norepinephrine
(1 mcg/min) x (60 min/hr) = 60 mcg/hr of Norepinephrine
(60 mcg/hr) / (1,000 mcg/ml) = 0.06 ml/hr of Norepinephrine
(0.06 ml/hr) x (12 hr) = 0.72 ml Norepinephrine
(12 ml Total Fluid Volume) - (0.72 ml Norepinephrine) = 11.28 ml D5W
The Result:
You will need 0.72 ml of Norepinephrine to mix with 11.28 ml of D5W. This will result in 0.1 mcg/kg/min = 1 ml/hr. To run the Norepinephrine CRI at 0.2 mcg/kg/min, increase the fluid rate of your CRI to 2 ml/hr
*Note Per Plumb's as of 01/16/23: "Norepinephrine is incompatible with aminophylline, sodium bicarbonate, ranitidine, or pantoprazole. Administer whole blood or plasma separately (via a Ytube and individual containers if given simultaneously). Dilute norepinephrine in dextrose 5% or dextrose 5% with 0.9% sodium chloride. Administration in 0.9% sodium chloride alone is not recommended as significant loss of potency can occur due to oxidation."
Sources:
Plumb's Veterinary Drugs App accessed from Instinct on 01/16/23.
Plumb's Veterinary Drugs App accessed from Instinct on 01/16/23.