Clinical Study
A Real-World, Multicenter Assessment of Drugs Requiring Weight-Based Calculations in Overweight, Adult Critically Ill Patients
Table 3
Dosing results for sedatives and neuromuscular blocker by weight category compared to recommendations in the literature.
| | Drugs | Weight category | Patients evaluated | Doses | Average dose | Median dose | Minimum | Maximum | Literature dose recommendation [19–22] REF package insert |
| | Propofol (mcg/kg/min) | Underweight | 1 | 4 | 17.50 | 20.00 | 10.00 | 20.00 | ICU sedation
Initial: 5 mcg/kg/min
Maintenance: 5–50 mcg/kg/min or higher to achieve a target sedation score
| | Normal weight | 5 | 14 | 36.67 | 35.50 | 10.00 | 85.50 | | Overweight | 6 | 44 | 45.83 | 50.00 | 6.50 | 75.00 | | Obese | 4 | 50 | 36.67 | 37.50 | 5.00 | 60.00 | | Extremely obese | 7 | 20 | 21.17 | 10.17 | 8.39 | 101.67 |
| | Midazolam (mcg/kg/min) | Underweight | 0 | 0 | — | — | — | — | Loading dose: 0.17–0.83 mcg/kg/min
Maintenance: 0.33–1.67 mcg/kg/min | | Normal weight | 3 | 3 | 0.26 | 0.06 | 0.02 | 0.69 | | Overweight | 1 | 1 | 0.06 | 0.06 | 0.06 | 0.06 | | Obese | 3 | 28 | 8.81 | 7.50 | 0.14 | 20.00 | | Extremely obese | 1 | 6 | 0.24 | 0.26 | 0.06 | 0.41 |
| | Fentanyl (mcg/kg/min) | Underweight | 0 | 0 | — | — | — | — | Mechanically-ventilated patients: 0.01–0.17 mcg/kg/min | | Normal weight | 5 | 8 | <0.01 | <0.01 | <0.01 | 0.01 | | Overweight | 8 | 15 | 0.01 | 0.01 | <0.01 | 0.01 | | Obese | 5 | 9 | 0.02 | 0.02 | 0.02 | 0.02 | | Extremely obese | 4 | 7 | 0.03 | 0.03 | 0.02 | 0.04 |
| | Rocuronium (mcg/kg/min) | Underweight | 0 | 0 | — | — | — | — | Tracheal intubation
450–600 mcg/kg
Rapid sequence intubation
Load: 600–1200 mcg/kg IV
Continuous infusion: 8–12 mcg/kg/min | | Normal weight | 0 | 0 | — | — | — | — | | Overweight | 0 | 0 | — | — | — | — | | Obese | 1 | 35 | 7.51 | 7.00 | 3.00 | 12.00 | | Extremely obese | 0 | 0 | — | — | — | — |
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