Sedation/Analgesia, PICU, Mechanically Ventilated Patient — Converting IV to Enteral Sedation - Calculating the Dose for Benzodiazepines — Clinical Pathway: ICU

Sedation/Analgesia, Mechanically Ventilated Patient Clinical Pathway — PICU

Converting IV to Enteral Benzodiazepines — Calculating the Enteral Dose

Please note: When considering enteral conversion for patient > 50 kg wean continuous infusion until threshold for maximum enteral dose is reached.

Continuous Medication Infusion Enteral Agent Typical Maximum Dose
Midazolam 0.15 mg/kg/hr
  • Diazepam
  • Lorazepam
  • 0.27 mg/kg/DOSE every 6 hours
  • 0.18 mg/kg/DOSE every 4 hours
  • 10 mg/DOSE
  • 5 mg/DOSE
Midazolam < 0.15 mg/kg/hr
  • Calculate enteral diazepam equivalent
    • Midazolam ___ mg/kg/hr x ___ kg x 1.8 = ___ mg enteral diazepam/dose
    • Calculated dose should be given every 6 hours
  • Calculate enteral lorazepam equivalent
    • Midazolam ___ mg/kg/hr x ___ kg x 1.2 = ___ mg enteral lorazepam/dose
    • Calculated dose should be given every 4 hours

Reference

Evaluation of IV to Enteral Benzodiazepine Conversion Calculations in a Pediatric Intensive Care Setting