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Topic:Hemodynamics

Hemodynamics in horses refers to the study of blood flow and the forces involved in circulation within the equine cardiovascular system. It encompasses the examination of heart function, blood pressure, and the distribution of blood to various tissues and organs. Key parameters in equine hemodynamics include cardiac output, vascular resistance, and blood volume. These factors are integral to understanding how horses respond to exercise, stress, and various health conditions. This page aggregates peer-reviewed research studies and scholarly articles that explore the mechanisms, measurement techniques, and clinical implications of hemodynamic processes in equine physiology and veterinary medicine.
General anesthesia in horses on fluid and electrolyte therapy.
The Veterinary clinics of North America. Equine practice    February 14, 2013   Volume 29, Issue 1 169-178 doi: 10.1016/j.cveq.2012.11.009
Snyder LB, Wendt-Hornickle E.The purpose of this article is to update the community of veterinarians performing general anesthesia in horses on fluid therapy. The rationale behind intraoperative fluid therapy, fluid dynamics, and various fluid options (crystalloids, hypertonic saline, colloids) is discussed. Additionally, electrolytes (calcium, potassium, and sodium) are included in the discussion in relation to general anesthesia and intraoperative fluid management.
Drugs for cardiovascular support in anesthetized horses.
The Veterinary clinics of North America. Equine practice    February 1, 2013   Volume 29, Issue 1 19-49 doi: 10.1016/j.cveq.2012.11.011
Schauvliege S, Gasthuys F.Despite the use of balanced anesthesia and fluids, drugs for cardiovascular support are often needed in anesthetized horses. Antimuscarinics can be used to treat bradycardia unrelated to hypertension. Vasopressors can be useful when hypotension is caused by vasodilation and/or when the effect of fluids and inotropes is insufficient. In most cases, however, inotropes, including sympathomimetics, calcium salts, and phosphodiesterase inhibitors, are preferred. Of the β-sympathomimetics, dobutamine remains the agent of choice. Calcium salts are mainly useful in hypocalcemic patients. Phosphodiest...
Cardiac output monitoring in horses.
The Veterinary clinics of North America. Equine practice    January 17, 2013   Volume 29, Issue 1 155-167 doi: 10.1016/j.cveq.2012.11.002
Shih A.Cardiac output (CO) is the volume of blood pumped out by the heart in 1 minute. Monitoring of CO can guide therapy and improve clinical outcome in critically ill patients and during anesthesia. Although there is increasing research into clinically useful methods of monitoring CO in equine patients, there are limitations to the available methods. There are 4 basic methods of measuring CO: (1) indicator methods, (2) a derivation of the Fick principle, (3) arterial pulse wave analysis, and (4) imaging diagnostic techniques. This article discusses the importance of CO, available technology, and ch...
Doppler and volumetric echocardiographic methods for cardiac output measurement in standing adult horses.
Journal of veterinary internal medicine    January 16, 2013   Volume 27, Issue 2 324-330 doi: 10.1111/jvim.12034
McConachie E, Barton MH, Rapoport G, Giguère S.Cardiac output (CO) is not routinely measured in critically ill adult horses because of invasiveness of currently validated methods. Noninvasive CO monitoring would complement clinical assessment of hemodynamic status in adult horses. Objective: Volumetric methods for measuring CO will have better agreement with lithium dilution than Doppler-based methods. Methods: Eight healthy adult horses. Methods: Prospective study. CO was manipulated with continuous rate infusions of dobutamine and romifidine to achieve high and low CO states, respectively. At each level, CO was measured by lithium diluti...
Anesthetic management of a horse with traumatic pneumothorax.
The Canadian veterinary journal = La revue veterinaire canadienne    December 4, 2012   Volume 53, Issue 6 648-652 
Chesnel MA, Aprea F, Clutton RE.A traumatic pneumothorax and severe hemorrhage were present in a mare with a large thoracic wall defect, lung perforation, and multiple rib fractures. General anesthesia was induced to allow surgical exploration. We describe the anesthetic technique, and discuss the management of the ventilatory, hemodynamic, and metabolic disturbances encountered. Gestion de l’anesthésie générale d’un cheval avec un pneumothorax d’origine traumatique. Nous décrivons le cas d’une jument présentée avec un important déficit de la paroi thoracique d’origine traumatique, une perforation pulmonaire...
Influence of atrioventricular interaction on mitral valve closure and left ventricular isovolumic contraction measured by tissue Doppler imaging.
Circulation. Cardiovascular imaging    November 28, 2012   Volume 6, Issue 1 109-116 doi: 10.1161/CIRCIMAGING.112.978692
Decloedt A, Verheyen T, Sys S, De Clercq D, Bijnens B, van Loon G.The influence of atrioventricular (AV) interaction on mitral valve closure (MVC) and left ventricular (LV) isovolumic contraction is not fully clarified. We investigated the relationship among AV delay, MVC, and LV isovolumic contraction using a horse model because of the low heart rate and physiologically long AV delay. Results: Six horses were evaluated during sinus rhythm, right ventricular pacing without preceding atrial contraction, and dual-chamber pacing at AV delays of 150 to 350 ms, programmed at a constant rate. Right parasternal 4-chamber views were recorded for simultaneous measure...
Use of near-infrared spectroscopy to identify trends in regional cerebral oxygen saturation in horses.
Equine veterinary journal    November 23, 2012   Volume 45, Issue 4 470-475 doi: 10.1111/evj.12001
McConnell EJ, Rioja E, Bester L, Sanz MG, Fosgate GT, Saulez MN.Alterations in cerebral haemodynamics may contribute to perianaesthetic complications in horses. Near-infrared spectroscopy (NIRS) is frequently used intraoperatively in man to provide information regarding cerebral perfusion. Objective: To determine whether NIRS can identify trends in regional cerebral oxygen saturation (rSO2) in horses and whether there is a correlation between rSO2 and venous oxygen tensions. Methods: A cerebral oximeter sensor recorded rSO2 from the dorsal sagittal sinus of 6 healthy horses. Values for rSO2, arterial and venous oxygen and carbon dioxide tensions (PaO2, PvO...
Efficacy of epidural lidocaine combined with tramadol or neostigmine on perineal analgesia in the horse.
Equine veterinary journal    October 23, 2012   Volume 45, Issue 4 497-502 doi: 10.1111/j.2042-3306.2012.00654.x
DeRossi R, Módolo TJ, Maciel FB, Pagliosa RC.Short duration of analgesia is among the limitations of a single epidural injection with lidocaine in horses. Objective: To evaluate the effectiveness and safety of epidural lidocaine in combination with either tramadol or neostigmine for perineal analgesia in horses. Methods: Epidural catheters were placed in 6 saddle horses that then were given 3 treatments: 2% lidocaine (0.2 mg/kg bwt) alone, 2% lidocaine (0.2 mg/kg bwt) plus tramadol (0.5 mg/kg bwt), and 2% lidocaine (0.2 mg/kg bwt) plus neostigmine (1.0 μg/kg bwt). The order of treatments was randomised. Haemodynamic variables, respirato...
Lithium dilution, pulse power analysis, and continuous thermodilution cardiac output measurements compared with bolus thermodilution in anaesthetized ponies.
British journal of anaesthesia    August 27, 2012   Volume 109, Issue 6 864-869 doi: 10.1093/bja/aes269
Ambrisko TD, Coppens P, Kabes R, Moens Y.This study compares cardiac output (CO) measurements obtained by lithium dilution (LiDCO), pulse power analysis (PulseCO), and continuous thermodilution (CTD) with bolus thermodilution (BTD) in ponies. Methods: Eight isoflurane-anaesthetized Shetland ponies received xylazine, ketamine, and midazolam infusions (0.3, 1.2, and 0.018 mg kg(-1) h(-1), respectively). CO was measured with BTD, CTD, LiDCO, and PulseCO. Lithium was injected into the jugular vein and blood was sampled from the facial artery for lithium detection and this artery was also used for PulseCO. Measurements were obtained durin...
Effects on cardiopulmonary function and oxygen delivery of doses of romifidine and xylazine followed by constant rate infusions in standing horses.
Veterinary journal (London, England : 1997)    July 28, 2012   Volume 195, Issue 2 228-234 doi: 10.1016/j.tvjl.2012.06.036
Ringer SK, Schwarzwald CC, Portier KG, Ritter A, Bettschart-Wolfensberger R.The objective of this study was to compare the cardiopulmonary effects of a xylazine or romifidine loading-dose, followed by a constant rate infusion (CRI) of the same α(2)-agonist. Nine research horses were treated in a randomized, blinded, crossover design with xylazine or romifidine. After instrumentation, a loading dose of intravenous xylazine (1mg/kg) or romifidine (80μg/kg) was administered, immediately followed by a CRI of xylazine (0.69mg/kg/h) or romifidine (30μg/kg/h) for a duration of 2h. Cardiopulmonary variables were recorded before bolus administration, during CRI, and for 1h ...
Direct intra-abdominal pressures and abdominal perfusion pressures in unsedated normal horses.
Journal of veterinary emergency and critical care (San Antonio, Tex. : 2001)    July 5, 2012   Volume 22, Issue 4 441-446 doi: 10.1111/j.1476-4431.2012.00774.x
Hurcombe SD, Scott VH.To determine whether direct intra-abdominal pressures (IAP) and calculated direct abdominal perfusion pressures (APP) are location dependent within the abdomen of standing horses. We hypothesize that IAP will be increased and calculated APP will be decreased at a ventral abdominal location (V) when compared to values obtained from the left (LFl) or right flank (RFl). Methods: Prospective experimental design. Methods: University-based equine research facility. Methods: Seven healthy adult horses, 4 geldings and 3 mares. Methods: Measurements of direct IAP obtained from the RFl, LFl, and V locat...
Pulse pressure variation and systolic pressure variation in horses undergoing general anesthesia.
Journal of veterinary emergency and critical care (San Antonio, Tex. : 2001)    June 19, 2012   Volume 22, Issue 3 372-375 doi: 10.1111/j.1476-4431.2012.00746.x
Fielding CL, Stolba DN.Changes in arterial pressure due to respiratory phases have been used to predict fluid responsiveness in a number of species and pulse pressure variation (PPV) and systolic pressure variation (SPV) are commonly used. The relationship between PPV and SPV has not been described in horses. Objective: To describe and compare PPV and SPV values of horses under general anesthesia. Methods: Twenty-six horses undergoing general anesthesia and receiving mechanical ventilation were enrolled in the study. Recordings of maximal and minimal values of pulse pressure and systolic pressure were calculated eve...
Uterine haemodynamics in young and aged pregnant mares measured using Doppler ultrasonography.
Equine veterinary journal. Supplement    May 19, 2012   Issue 41 15-21 doi: 10.1111/j.2042-3306.2011.00446.x
Ousey JC, Kölling M, Newton R, Wright M, Allen WR.Aged mares with endometrosis suffer higher rates of pregnancy loss than young mares, due to poor placental development. Reduced uterine blood supply may be one contributory factor. Objective: To measure uterine artery (UA) blood flow and other Doppler indices throughout pregnancy and compare placental and foal development in young mares and aged mares. Methods: Thoroughbred mares were grouped according to age and endometrial biopsy score: 1) 6 young mares (mean age 7.3 years, Category ); 2) 6 aged mares (mean age 18.3 years, Category II). Vascular pathology was nil or mild except in one aged m...
Changes in heart rate and heart rate variability during transportation of horses by road and air.
American journal of veterinary research    March 29, 2012   Volume 73, Issue 4 515-521 doi: 10.2460/ajvr.73.4.515
Ohmura H, Hobo S, Hiraga A, Jones JH.To determine the influence of transportation by road and air on heart rate (HR) and HR variability (HRV) in horses. Animals-6 healthy horses. Methods: ECG recordings were obtained from horses before (quarantine with stall rest [Q]; 24 hours) and during a journey that included transportation by road (RT; 4.5 hours), waiting on the ground in an air stall (W; 5.5 hours), and transportation by air (AT; 11 hours); HR was determined, and HRV indices of autonomic nervous activity (low-frequency [LF; 0.01 to 0.07 Hz] and high-frequency [HF; 0.07 to 0.6 Hz] power) were calculated. Results: Mean ± SD H...
Quantitative response of volumetric variables measured by a new ultrasound dilution method in a juvenile model of hemorrhagic shock and resuscitation.
Resuscitation    January 25, 2012   Volume 83, Issue 8 1031-1037 doi: 10.1016/j.resuscitation.2012.01.014
Vigani A, Shih A, Queiroz P, Pariaut R, Gabrielli A, Thuramalla N, Bandt C.New volumetric variables of preload, such as total end-diastolic volume index (TEDVI) and active circulation volume index (ACVI) and central blood volume index (CBVI), may represent good indicators of preload and predictors of fluid responsiveness. During acute changes of intravascular volume these variables would allow a more accurate intervention. Objective: The aim of the present study was to investigate the changes in TEDVI, ACVI, CBVI in a juvenile model of hemorrhagic shock and resuscitation. Methods: Twelve anaesthetized ponies (3-8 months of age) were studied at normovolaemia (BASE), a...
Mating behavior increases workload of the heart in Thoroughbred stallions.
The Journal of veterinary medical science    November 25, 2011   Volume 74, Issue 4 423-428 doi: 10.1292/jvms.11-0360
Hatazoe T, Kubota C, Fujiki M, Misumi K.To evaluate the influence of mating behavior on cardiac function, changes in heart rate (HR), electrocardiogram (ECG), hematocrit (Hct) and serum concentration of alpha-atrial natriuretic peptide (alpha-ANP) were evaluated in 10 clinically sound Thoroughbred stallions before and after mating behavior. The stallions were submitted twice to experimental pseudomating in the same month in 2009 and 2010. Measurements and blood samples were collected at a stable before mating (baseline) and at a covering yard before and after mating. ECG was recorded by a Holter-ECG system. Arrhythmias were detected...
Correlation between jugular and central venous pressures in laterally recumbent horses.
Veterinary anaesthesia and analgesia    October 13, 2011   Volume 38, Issue 6 580-583 doi: 10.1111/j.1467-2995.2011.00667.x
Tam K, Rezende M, Boscan P.To compare and correlate right atrial pressure, which represents central venous pressure (CVP) to jugular vein pressure (JVP) in laterally recumbent horses under anesthesia. Methods: Retrospective clinical trial. Methods: Seven adult healthy horses (411 ± 8.7 kg). Methods: Horses were sedated with IV xylazine and anesthesia was obtained with IV ketamine and diazepam. Anesthesia was maintained with sevoflurane in oxygen. All horses were positioned in left lateral recumbency. An 8F catheter introducer was inserted into the right jugular vein to measure JVP. An 8F catheter introducer was i...
Effects of a constant rate infusion of detomidine on cardiovascular function, isoflurane requirements and recovery quality in horses.
Veterinary anaesthesia and analgesia    October 13, 2011   Volume 38, Issue 6 544-554 doi: 10.1111/j.1467-2995.2011.00659.x
Schauvliege S, Marcilla MG, Verryken K, Duchateau L, Devisscher L, Gasthuys F.To examine the influence of a detomidine constant rate infusion (CRI) on cardiovascular function, isoflurane requirements and recovery quality in horses undergoing elective surgery. Methods: Prospective, randomized, blinded, clinical trial. Methods: Twenty adult healthy horses. Methods: After sedation (detomidine, 10 μg kg(-1) intravenously [IV]) and induction of anaesthesia (midazolam 0.06 mg kg(-1) , ketamine 2.2 mg kg(-1) IV), anaesthesia was maintained with isoflurane in oxygen/air (inspiratory oxygen fraction 55%). When indicated, the lungs were mechanically ventilated. Dobut...
Uterine artery blood flow remains unchanged in pregnant mares in response to short-term administration of pentoxifylline.
Theriogenology    September 29, 2011   Volume 77, Issue 2 430-436 doi: 10.1016/j.theriogenology.2011.08.018
Bailey CS, Sper RB, Schewmaker JL, Buchanan CN, Beachler TM, Pozor MA, Whitacre MD.The objective of this study was to use Doppler ultrasound technology to determine whether pentoxifylline administration increased uterine blood flow in normal pregnant pony mares. Thirteen pregnant pony mares between 18 and 190 d of gestation (mean ± SEM, 101 ± 55) were utilized for the study during two trial periods. In each trial, pentoxifylline (17 mg/kg by mouth every 12h, diluted in syrup) was administered to half of the mares for 3 d, while the other mares were treated with syrup only. Doppler measurements were obtained from the right and left uterine arteries from each mare for 2 d pr...
Preliminary investigation of concurrent administration of phenylbutazone and romifidine in healthy horses.
Veterinary anaesthesia and analgesia    August 13, 2011   Volume 38, Issue 5 505-509 doi: 10.1111/j.1467-2995.2011.00642.x
Kruger K, Stegmann GF, Becker PJ.To characterize the cardiorespiratory and electrocardiographic effects of the combined administration of phenylbutazone and romifidine. Methods: Prospective four-period, four-treatment, blinded, randomized, crossover trial. Methods: Five, healthy, mixed breed horses. Methods: Prior to treatment administration, a catheter was introduced into the intra-thoracic cranial vena cava via the jugular vein and a subcutaneously located carotid artery was catheterised. All treatments were administered intravenously (IV) and consisted of saline placebo (PLC), phenylbutazone (PBZ, 4.4 mg kg(-1) ) romifidin...
Effect of general anesthesia on plasma cardiac troponin I concentrations in healthy horses.
Journal of veterinary cardiology : the official journal of the European Society of Veterinary Cardiology    August 6, 2011   Volume 13, Issue 3 163-169 doi: 10.1016/j.jvc.2011.04.005
Slack J, Boston R, Driessen B, Reef V.To evaluate the effect of general anesthesia on plasma cTnI concentrations in horses. Methods: Thirty-two horses undergoing general anesthesia and either elective surgery or MRI without surgery were prospectively studied. Twenty-nine horses (22 surgical, 7 imaging) completed the study. Plasma cTnI concentrations were determined prior to anesthesia and at 6, 12 and 24 h following discontinuation of the inhalant anesthetic. Results: All horses had cTnI values within the reference range at all time points. Six horses (21%) developed detectable cTnI 6 or 12 h following anesthesia. Risk factors f...
Long-term facial artery catheter implantation for serial arterial blood sampling and invasive arterial blood pressure measurement in horses.
Veterinary journal (London, England : 1997)    July 23, 2011   Volume 192, Issue 3 541-543 doi: 10.1016/j.tvjl.2011.06.031
Dias DP, Teixeira LG, Canola PA, Albernaz RM, Marques JA, Neto JC.The purpose of this investigation was to evaluate surgical catheter implantation in the facial artery of horses and the long-term maintenance of such arteries using heparin and ascorbic acid as filling solution. Nine horses were implanted with a polyurethane catheter. The catheters were flushed with a heparin/ascorbic acid solution every 8h and remained patent for 25 days. Arterial blood samples were collected twice a day, and one exercise test that included serial blood samples and arterial pressure recordings was performed on a treadmill. Polyurethane catheters surgically implanted in the fa...
Effect of pentoxifylline treatment on testicular perfusion and semen quality in Miniature horse stallions.
Theriogenology    July 12, 2011   Volume 76, Issue 6 1027-1035 doi: 10.1016/j.theriogenology.2011.05.005
Pozor MA, Muehlhaus J, King A, Macpherson ML, Troedsson MH, Bailey CS.The objective was to investigate the effects of pentoxifylline (PTX) on testicular perfusion and sperm production in stallions. In a preliminary study, six mature Miniature horse stallions were given 0, 8.5, or 17.0 mg/kg of PTX orally, twice daily, for 3 d. Total Arterial Blood Flow Rate (TABFR) was higher (P < 0.05) in all treated versus control stallions during and after treatment. Two months later (during the fall and winter), the same stallions received either 0 or 17 mg/kg of PTX orally, twice daily for 60 d. Resistance and pulsatility indices (RI and PI, respectively) decreased in PT...
Physiological and blood biochemical variables in horses exercising on a treadmill submerged in water.
Journal of animal physiology and animal nutrition    June 21, 2011   Volume 96, Issue 4 563-569 doi: 10.1111/j.1439-0396.2011.01179.x
Lindner A, Wäschle S, Sasse HH.The blood lactate concentration (LA) and heart rate (HR) of 10 horses exercising in water on a treadmill were examined. With the water at 10 and 50% of the withers height (WH), the blood LA increased up to mean values around 1.9 mm during the standardized exercise test (SET) until after step 3 of 5 (each step lasted 5 min, speed increasing step by step). Thereafter, blood LA of horses remained constant, while with the water at 80% of WH, the blood LA decreased from the mean peak of 2.16 ± 0.62 mm after the 4th step. The HR of the horses increased to 132 ± 14 beats/min until the 3rd step of S...
Effects of constant rate infusion of lidocaine and ketamine, with or without morphine, on isoflurane MAC in horses.
Equine veterinary journal    June 13, 2011   Volume 43, Issue 6 721-726 doi: 10.1111/j.2042-3306.2010.00355.x
Villalba M, Santiago I, Gomez de Segura IA.Lidocaine and ketamine are administered to horses as a constant rate infusion (CRI) during inhalation anaesthesia to reduce anaesthetic requirements. Morphine decreases the minimum alveolar concentration (MAC) in some domestic animals; when administered as a CRI in horses, morphine does not promote haemodynamic and ventilatory changes and exerts a positive effect on recovery. Isoflurane-sparing effect of lidocaine, ketamine and morphine coadministration has been evaluated in small animals but not in horses. Objective: To determine the reduction in isoflurane MAC produced by a CRI of lidocaine ...
Repeatability, reproducibility, and effect of head position on central venous pressure measurement in standing adult horses.
Journal of veterinary internal medicine    March 24, 2011   Volume 25, Issue 3 575-578 doi: 10.1111/j.1939-1676.2011.0701.x
Norton JL, Nolen-Walston RD, Underwood C, Boston R, Slack J, Dallap BL.Central venous pressure (CVP) is a used as an estimation of intravascular volume status in various species. Techniques for measuring CVP in horses have been described, but the repeatability of these readings at a single time point or over time has not been established. Objective: That CVP measurements in healthy adult horses would be repeatable at each time point, that these readings would be reproducible over time, and that alteration in head position relative to the heart would alter CVP. Methods: Ten healthy adult research horses. Methods: In an experimental study, horses were instrumented ...
Comparison of water manometry to 2 commercial electronic pressure monitors for central venous pressure measurement in horses.
Journal of veterinary internal medicine    January 31, 2011   Volume 25, Issue 2 303-306 doi: 10.1111/j.1939-1676.2010.0670.x
Norton JL, Nolen-Walston RD, Underwood C, Slack J, Boston R, Dallap BL.Central venous pressure (CVP) customarily has been measured in veterinary patients with water manometry. However, many institutions are now using stallside electronic monitors in both anesthesia and intensive care units for many aspects of patient monitoring. Objective: Electronic stall side monitoring devices will agree with water manometry for measurement of CVP in horses. Methods: Ten healthy adult horses from the university research herd. Methods: Central venous catheters were placed routinely, and measurements were obtained in triplicate with each of the 3 methods every 12 hours for 3 day...
Longitudinal study of the renin angiotensin aldosterone system in purebred Spanish broodmares during pregnancy.
Theriogenology    January 8, 2011   Volume 75, Issue 7 1185-1194 doi: 10.1016/j.theriogenology.2010.11.029
Satué K, Domingo R.During pregnancy, the coordinated interaction of the components of the renin-angiotensin-aldosterone system (RAAS) plays a vital role in accommodating the cardiovascular, haemodynamic and haematological needs imposed by foetal development and the placenta. This significantly influences the birth weight of the neonate and foetal viability. Although the evolution of each of the components of this system has been widely described in various species, it has not yet been clarified in the mare. Thus, the objectives of the present research were: 1) to establish reference values for renin (REN), angio...
What is your diagnosis? Ruptured right aortic sinus (sinus of Valsalva) aneurysm, valvular endocarditis, and cardiac volume overload with early failure.
Journal of the American Veterinary Medical Association    December 16, 2010   Volume 237, Issue 12 1371-1372 doi: 10.2460/javma.237.12.1371
Norman TE, Achen SE, Coleman MC, Schroeder JD.No abstract available
The effects of hypohydration on central venous pressure and splenic volume in adult horses.
Journal of veterinary internal medicine    November 23, 2010   Volume 25, Issue 3 570-574 doi: 10.1111/j.1939-1676.2010.0641.x
Nolen-Walston RD, Norton JL, Navas de Solis C, Underwood C, Boston R, Slack J, Dallap BL.Central venous pressure (CVP) is used in many species to monitor right-sided intravascular volume status, especially in critical care medicine. Objective: That hypohydration in adult horses is associated with a proportional reduction in CVP. Methods: Ten healthy adult horses from the university teaching herd. Methods: In this experimental study, horses underwent central venous catheter placement and CVP readings were obtained by water manometry. The horses were then deprived of water and administered furosemide (1 mg/kg IV q6h) for up to 36 hours. Weight, CVP, vital signs, PCV, total protein (...
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