Sedation/Analgesia, CICU, Mechanically Ventilated Patient — Less or Equal to 7 Days — Clinical Pathway: ICU

Sedation/Analgesia in Mechanically Ventilated Patient Clinical Pathway — CICU

Wean Examples: ≤ 7 days of Continuous Therapy

Patient (10 kg) on therapy for 5 days with fentanyl infusion currently at a rate of 2 mcg/kg/hr and midazolam currently at a rate of 0.1 mg/kg/hr. The following stepwise reduction is recommended at 8 to 12 hour intervals with a PRN equal to 1/2 current dose for any withdrawal concerns.

  Fentanyl     Midazolam
Step Infusion Rate PRN   Step Infusion Rate PRN
1 1.6 mcg/kg/hr 0.8 mcg/kg   1 0.08 mg/kg/hr 0.04 mg/kg
2 1.2 mcg/kg/hr 0.6 mcg/kg   2 0.06 mg/kg/hr 0.03 mg/kg
3 0.8 mcg/kg/hr 0.4 mcg/kg   3 0.04 mg/kg/hr 0.02 mg/kg
4 0.4 mcg/kg/hr 0.2 mcg/kg   4 0.02 mg/kg/hr 0.01 mg/kg
5 Discontinue     5 Discontinue