Constant Rate Infusion (CRI) Calculator
Calculation Summary:
Understanding Constant Rate Infusions (CRI)
A Constant Rate Infusion (CRI) is a technique used in clinical medicine, particularly in emergency and intensive care, to deliver a precise amount of medication over a specific period. Unlike bolus injections which cause "peaks and valleys" in drug plasma concentration, a CRI maintains a steady-state therapeutic level, improving efficacy and reducing the risk of toxicity.
The CRI Formula
To calculate how much of a drug should be added to a fluid bag, we use the following mathematical logic:
- Determine mg needed per hour: (Dosage in mcg/kg/min × Weight in kg × 60 minutes) / 1000
- Determine hours the bag will last: Total Bag Volume / Fluid Rate per hour
- Total drug required: (mg needed per hour / drug concentration) × total hours
Common Clinical Examples
CRI delivery is frequently used for analgesia, blood pressure management, and seizure control. Typical drugs include:
- Lidocaine: Often used for cardiac arrhythmias or visceral pain management.
- Fentanyl: A potent opioid used for severe intra-operative and post-operative pain.
- Ketamine: Used at sub-anesthetic doses for NMDA antagonism and wind-up pain prevention.
- Metoclopramide: Used for gastrointestinal motility disorders.
Calculated Case Study
Suppose you have a 20kg canine patient requiring a Lidocaine CRI at 50 mcg/kg/min. Your drug concentration is 20 mg/mL. You are using a 500 mL saline bag, and the patient is receiving fluids at 40 mL/hr.
Using the calculator above, you would find that you need to add 37.5 mL of Lidocaine to the 500 mL fluid bag to achieve the desired delivery rate.