Mivacurium:

Intravenous nondepolarizing neuromuscular blocking agent

ECMO Dose Adjustment:

NONE

Renal Impairment Dose Adjustment:

NONE

CRRT Dose Adjustment:

NONE

Hepatic Impairment Dose Adjustment:

NONE

Adult Starting Dose^:

Adult Emergency Dose: 0.2 mg/kg IV x 1

Adult Intermittent: 0.05–0.1 mg/kg IV every 30–60 min

Adult Continuous: 5–6 mcg/kg/min

Pediatric Starting Dose^:

Pediatric Emergency Dose: 0.2 mg/kg IV x 1

Pediatric Intermittent: 0.1 mg/kg IV every 20–30 min

Pediatric Continuous Infusion: 6–8 mcg/kg/min

Neonatal Starting Dose^:

Emergency dose: 0.2 mg/kg IV x 1

Intermittent: 0.1 mg/kg IV every 20–30 min

Continuous infusion: 6–8 mcg/kg/min

^Always use the lowest effect dose to achieve an objective endpoint (e.g., train-of-four, ventilator synchrony) and ensure adequate pain control and deep sedation prior to and during administration of neuromuscular blocking agents; reduced cholinesterase activity may lead to prolonged pharmacologic effect.