TAILIEUCHUNG - ADVANCED PAEDIATRIC LIFE SUPPORT - part 3

được tăng lên đến 10-20 mg / kg mỗi tháng truyền sản xuất dopamine phút nhịp tim nhanh, co mạch, và ectopy thất. Xâm nhập vào mô của dopamine có thể hoại tử mô sản xuất địa phương. Dopamine và catecholamine khác là bất hoạt trong các giải pháp kiềm và một phần do không nên Hãy trộn với sodium bicarbonate. | THE MANAGEMENT OF CARDIAC ARREST be increased to 10-20 micrograms kg per minute Dopamine infusions may produce tachycardia vasoconstriction and ventricular ectopy. Infiltration of dopamine into tissues can produce local tissue necrosis. Dopamine and other catecholamines are partially inactivated in alkaline solutions and therefore should not be mixed with sodium bicarbonate. Infusion concentration 15mg kg in 50 ml of 5 dextrose or normal saline will give 5 micrograms kg min if run at 1 ml h. To give 2-20 micrograms kg min give 0-4-4 ml h of the above dilution. Epinephrine An epinephrine infusion is used in the treatment of shock with poor systemic perfusion from any cause that is unresponsive to fluid resuscitation. Epinephrine may be preferable to dobutamine or dopamine in patients with severe hypotensive shock and in very young infants in whom other inotropes may be ineffectual The infusion is started at 0-1-0-3 microgram kg per minute and increased to 1 microgram kg per minute depending on clinical response. Epinephrine should be infused only into a secure intravenous line because tissue infiltration may cause local ischaemia and ulceration. Infusion concentration 0-3 mg kg in 50ml of 5 dextrose or normal saline will give 0-1 microgram kg min if run at a rate of 1 ml h. To give 0-1-2-0micrograms kg h give 1-20 ml h of the above dilution. 3 mg kg in 50 ml of 5 dextrose or normal saline will give 1 microgram kg min if run at a rate of 1ml h. To give 0-5-2-0micrograms kg h give 0-5-2 ml h of the above dilution. Hypothermia Recent data suggest that there is some evidence that post-arrest hypothermia core temperatures of 33 to 36 C may have beneficial effects on neurological recovery but there is insufficient evidence to recommend the routine use of hypothermia. Current recommendations are that post-arrest patients with core temperatures less than C should not be actively rewarmed unless the core temperature is 33 C when they should be rewarmed to 34 C. .

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