Table 2.

Organ sparing hormonal therapy

Drug	Dosage	Comments
Thyroxine T4	Administer 10 U regular insulin with 1 ampule of D50 (unless glucose > 300 mg/dl) then	Inotropic effect, can be used as a pressor
	20 mcg T4 IV bolus (mixed 200 mcg in 500 ml NS) followed by	Causes hyperkalemia with bolus- must administer insulin and D50 prior to initiation
	10 mcg/h of T4 IV maximum dose 20 mcg/h	T4 shown to be more beneficial than T3 [4, 12, 14, 18]
Vasopressin	0.5 units/h IV (25 u in 250 ml NS or D5W)	Check for DI:
	maximum dose 6 u/h	UOP ≥ 5 cc/kg/h for ≥ 2 hours, urine specific gravity < 1.005, serum Na > 145 meq/l, OR serum osmolality > 300 mOsm/kg and urine osmolarity < 200 mOsm/kg
		Titration should be based on BP, UOP, Na+ levels and urine specific gravity
Insulin	1 unit/h IV (25 u in 250 ml NS)	Adjust to maintain glucose 100–140 mg/dl
Methylprednisolone	15 mg/kg IV bolus repeat daily	Improves potential for lung donation

D50 50% dextrose solution, IV intravenous