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Review
. 2020 Jun 8;24(1):315.
doi: 10.1186/s13054-020-03040-z.

Drug dosing in the critically ill obese patient-a focus on sedation, analgesia, and delirium

Brian L Erstad  1 , Jeffrey F Barletta  2
Affiliations
Review

Drug dosing in the critically ill obese patient-a focus on sedation, analgesia, and delirium

Brian L Erstad et al. Crit Care. .

Abstract

Practice guidelines provide clear evidence-based recommendations for the use of drug therapy to manage pain, agitation, and delirium associated with critical illness. Dosing recommendations however are often based on strategies used in patients with normal body habitus. Recommendations specific to critically ill patients with extreme obesity are lacking. Nonetheless, clinicians must craft dosing regimens for this population. This paper is intended to help clinicians design initial dosing regimens for medications commonly used in the management of pain, agitation, and delirium in critically ill patients with extreme obesity. A detailed literature search was conducted with an emphasis on obesity, pharmacokinetics, and dosing. Relevant manuscripts were reviewed and strategies for dosing are provided.

Keywords: Critical illness; Drug-dosing; Obesity; Pharmacokinetics.

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Conflict of interest statement

BLE: No conflicts of interest.

JFB: Consultant for Wolters Kluwer.

Figures

Fig. 1
Fig. 1
Summary of dosing recommendations for medications used in the management of sedation, analgesia, and delirium in critically ill patients with obesity. Unless otherwise indicated, these recommendations apply for patients with more severe forms of obesity (i.e., BMI ≥ 40 kg/m2)
See this image and copyright information in PMC

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MeSH terms