Rocuronium:

Intravenous nondepolarizing neuromuscular blocking agent

ECMO Dose Adjustment:

NONE

Renal Impairment Dose Adjustment*:

YES—a decreased dose may be warranted in some patients.

CRRT Dose Adjustment:

NONE

Hepatic Impairment Dose Adjustment*:

YES—a decreased dose may be warranted in some patients.

Adult starting dose^:

Adult Emergency Dose: 1 mg/kg IV x 1

Adult Intermittent: 0.5–1 mg/kg IV every 30–60 min

Adult Continuous Infusion: 3–5 mcg/kg/min

Pediatric starting dose^:

Pediatric Emergency Dose: 1 mg/kg IV x 1

Pediatric Intermittent: 0.5–1 mg/kg IV every 30–60 min

Pediatric Continuous infusion: 5–7 mcg/kg/min

Neonatal starting dose^:

Neonatal Emergency Dose: 1 mg/kg IV x 1

Neonatal Intermittent: 0.5–1 mg/kg IV every 30–60 min

Neonatal Continuous Infusion: 5–7 mcg/kg/min

*Dose adjustment will be dependent on acuity and severity of impairment.

^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.