This application is intended to help medical professionals in the Veterinary industry to check their work in creating CRIs for patients.
There are three categories of CRIs that are addressed in this app:
Standard Infusions:
This category covers twenty-seven of the most typically used drugs needed for most continuous rate infusions (CRIs). This app allows for flexibility in formulation, allowing the user to create both syringe based and fluid bag based CRIs. The user can choose drug concentrations (based on published available concentrations) or can input their own. The user is responsible for checking that the appropriate concentration and drug dosage is used. The calculations here are fairly straight forward. Once the fields are filled in appropriately the following equations are used:
CRI Dose = Pet Weight (kg) * CRI Dosage * Time Factor * (Bag Volume(ml) / Drip Rate(ml/h))
*Where Time Factor = The conversion needed to get ml/hr for bag drip rates (minute vs hour vs day).
CRI Volume = CRI Dose / Concentration Value
Loading Dose = Pet Weight (kg) * Loading Dosage
CRI Dose and Loading Dose may be converted from ug to mg units according to the amount
of the drug calculated. Example: 1000ug will be converted to 1mg.
Propofol Infusions:
This portion of the app was created specifically since propofol is used undiluted whether for anesthesia purposes or for emergent anti-convulsant therapy. Both a loading dosage and CRI dose/volume are calculated in this app, the latter based on dosage and desired duration of CRI.
CRI Dose = Pet Weight (kg) * CRI Dosage (mg/kg/min) *Duration of CRI (in hours)
CRI volume = CRI dose/propofol concentration (10mg/ml)
Insulin Infusions:
Insulin can be given in bolus injections, or via an infusion for treatment of diabetic ketoacidosis. This portion of the app will calculate the amount of insulin needed for an insulin CRI (regular insulin only), and provides a chart with drip rates according to blood glucose measurements.
Selection of species (cat or dog) will determine the Insulin dosage. Once a Pet Weight is entered, the calculation used for the Insulin Dose is as follows:
Insulin dosage/240ml 0.9% NaCl bag = patient weight * units/kg (based on species (1.1u/kg for cats, 2.2 u/kg for dogs))
Mail Functionality:
All above categories have a Mail Results button in which you can send the results of the calculated CRI through e-mail to any address. When the button is pressed, a screen will pop up asking for patient name and patient number. These fields are optional. If they are left blank when the Done button is pressed, then the e-mail will not include these fields.
References:
References for drug names and suggested dosage values are from Plumb’s Veterinary Drug Handbook, by Donald C. Plumb (for standard infusions and propofol CRI). 6th edition. New Advances in the Treatment of Feline Diabetes Mellitus (DM), AAFP winter meeting notes, 1999 by Dr. Deborah Greco (for feline insulin CRI), Journal of the American Veterinary Association, April 1993;202(8):1266-72. by D K Macintire (Treatment of diabetic ketoacidosis in dogs by continuous low-dose intravenous infusion of insulin) (for canine insulin CRI).
