Q Is it appropriate to adjust body surface area and intravenously administered vasoactive medication dosage against daily weight changes in the intensive care unit? Because of these significant changes, is admission weight acceptable? Is there such a thing as “dry weight”? If so, how is it defined and measured?

A Brad Cooper, PharmD, replies:

As previously reviewed, there are no published data upon which to determine the best weight to use when dosing vasoactive agents such as dopamine, dobutamine, epinephrine, norepinephrine, and phenylephrine.1 Most studies with these medications report the dose used in terms of μg/kg/min without specifying whether actual body weight (ABW), ideal body weight (IBW), or dry weight was used. Even the published guidelines for the hemodynamic support of patients with sepsis do not address this topic.2 Typically, if otherwise unspecified in published clinical trials, most likely the ABW was used.

Body surface area is used...

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