Unique Plan Description: PULM Epoprostenol Nebulized-Continuous
Plan Selection Display: PULM Epoprostenol Nebulized-Continuous
PlanType: Medical                                 
Version: 1          
Begin Effective Date: 2021-07-01 05:53:00
End Effective Date: 2100-12-31 00:00:00
Last Updated Date: 2021-12-21 10:37:23
Available at all facilities: No

PULM Epoprostenol Nebulized-Continuous
Laboratory
	Blood Gases Arterial (ABG) - MH/WH/JE
		T;N, Stat, spec type = Blood
		Routine, Q2H-Sch, spec type = Blood
	Hemoglobin and Hematocrit
		T+1;0400, Routine, Q24H, spec type = Blood
Medications
		Epoprostenol Nebulized-Continuous GUIDELINES FOR USE- RESTRICTED TO Cardiothoracic Surgeons/Pulmonary Intensivists(NOTE)*
		<!DOCTYPE HTML PUBLIC "-//W3C//DTD HTML 4.0 Transitional//EN"><HTML><HEAD><META content="text/html; charset=windows-1252" http-equiv=Content-Type><STYLE> BODY margin:0; P margin:0 </STYLE><META name=GENERATOR content="MSHTML 11.00.9600.19963(NOTE)*
	epoprostenol inhalation 1500mcg/50mL
		1,500 mcg, EVERY BAG, 50 ng/kg/min
		50 mL, Nebulization-Continuous
			Comment: ***Use IBW for dosing*** rounded to nearest 10kg.  INHALATION ONLY.  Start at 50ng/kg/min; Max dose = 50ng/kg/min. Continue therapy if positive response goals met: PaO2 > 55 or any improvement in baseline PaO2/FiO2 ratio; After 2 hours of use if goal response is NOT met, RT to contact provider to discuss discontinuation of therapy; if discontinuation necessary, decrease dose by 10ng/kg/min q2hr until dose is 10ng/kg/min for 2hr and then discontinue nebulization unless provider states to discontinue without weaning;  if positive response to initial dosing, RT will decrease dose by 10ng/kg/min q2hr to lowest effective dose to maintain PaO2 > 55; after 2 hours at lowest dose of 10ng/kg/min, contact provider to discuss infusion discontinuation;  at any time during negative response discontinuation, dose reduction to lowest effective dose, or dose weaning, if PaO2 is < 55 or PaO2/FiO2 ratio declines > 15%, return to previous dose and notify provider;  Do Not stop nebulization abruptly unless directed to by provider -  doses must be weaned. Following discontinuation, monitor patient for rebound pulmonary hypertension for at least 60 minutes.

*Report Legend:
DEF - This order sentence is the default for the selected order
GOAL - This component is a goal
IND - This component is an indicator
INT - This component is an intervention
IVS - This component is an IV Set
NOTE - This component is a note
Rx - This component is a prescription
SUB - This component is a sub phase