Question

A 67 y/o male presents with severe respiratory distress and a systolic BP of 78/P. You have attempted fluid resuscitation; medical command has ordered a DOBUTamine drip at 5 mcg/kg/min.

What are the two endpoints to stop increasing this drip?

[C]

[D]

Answer 1

1. Increase in systolic blood pressure (SBP) to greater than 90 mmHg.

2. Development of adequate perfusion, as evidenced by improved mentation and urine output.

Step-by-step explanation:

In managing a critically ill 67-year-old male with severe respiratory distress and a systolic blood pressure (SBP) of 78/P, the use of a DOBUTamine drip at 5 mcg/kg/min has been initiated following fluid resuscitation. The first endpoint to halt the increment of the DOBUTamine drip is achieving an SBP greater than 90 mmHg. This reflects an improvement in the cardiac output and perfusion, essential for organ function and systemic oxygenation.

The second endpoint involves assessing overall perfusion through clinical markers. The cessation of the DOBUTamine drip is warranted when there is observable improvement in mentation and urine output. Mentation serves as an indicator of cerebral perfusion, while urine output reflects renal perfusion, both crucial in evaluating systemic perfusion status.

In critically ill patients, close monitoring of hemodynamic parameters and clinical signs is imperative. Adjustments in DOBUTamine therapy should be guided by a comprehensive assessment of the patient's response, ensuring optimal perfusion without risking adverse effects.