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Related Experiment Videos

Difference between the measured and ordered dose of catecholamine infusions

E M Allen1, D H Van Boerum, A F Olsen

  • 1Division of Pediatric Critical Care, Primary Children's Medical Center, Salt Lake City, UT 84113, USA.

The Annals of Pharmacotherapy
|November 1, 1995
PubMed
Summary

Accurate preparation of critical care infusions like dopamine, dobutamine, and epinephrine is vital. Daily preparation inaccuracies in these catecholamine infusions can significantly impact drug delivery to critically ill pediatric patients.

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Area of Science:

  • Pediatric critical care medicine
  • Clinical pharmacy
  • Pharmacology

Background:

  • Dopamine, dobutamine, and epinephrine are essential catecholamines used in critical care.
  • Accurate dosing of these vasoactive agents is crucial for hemodynamic stability in critically ill patients.

Purpose of the Study:

  • To measure actual concentrations of dopamine, dobutamine, and epinephrine in prepared infusates.
  • To compare measured concentrations with prescribed concentrations to assess drug preparation accuracy.

Main Methods:

  • Prospective study in a pediatric intensive care unit.
  • Analysis of 41 pediatric patients' infusates using High-Performance Liquid Chromatography (HPLC).
  • Comparison of measured catecholamine concentrations and doses with ordered values.

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Main Results:

  • Significant discrepancies found between ordered and measured doses of dopamine, dobutamine, and epinephrine due to preparation inaccuracies.
  • Failure to account for the HCl salt contributed to some, but not all, inaccuracies.
  • High interday variability in measured catecholamine dosage observed.

Conclusions:

  • Daily fluctuations in the preparation of dopamine, dobutamine, and epinephrine infusions are common.
  • These preparation inaccuracies can alter drug delivery to critically ill children.
  • Variability in infusion preparation may contribute to hemodynamic instability in pediatric patients.