The use of propofol for sedation of critically ill patients undergoing haemodiafiltration.
OBJECTIVE
To assess the requirement for propofol to provide sedation in critically ill patients in established renal failure during the commencement of haemodiafiltration.


METHODS
Prospective clinical study.


METHODS
ICU, University Hospital.


METHODS
10 adult patients. All were mechanically ventilated, had acute oliguric renal failure which necessitated continuous veno-venous haemodiafiltration and were receiving a continuous intravenous infusion of propofol for sedation. Sedation was assessed using a scoring system.


METHODS
Veno-venous haemodiafiltration.


RESULTS
Connection of the extracorporeal circuit produced a reduction in plasma propofol concentration in 7 out of 9 patients (one sample misplaced) with subsequent awakening in 3 of these 7 patients. The commencement of haemodiafiltration itself did not significantly influence the requirement for propofol (8 out of 10 patients).


CONCLUSIONS
Haemodiafiltration does not substantially influence the requirement for propofol but the initial introduction of the extracorporeal circuit will reduce plasma concentrations in the majority of patients. This may be due to haemodilution alone or absorption of plasma albumin (with propofol) onto the membrane.
Eddleston
J M
JM
Department of Anaesthesia, Manchester Royal Infirmary, UK.
Pollard
B J
BJ
Blades
J F
JF
Doran
B
B
D018806:APACHE; D058186:Acute Kidney Injury / Q000628:therapy*; D000328:Adult; D000368:Aged; D003422:Critical Care; D004359:Drug Therapy, Combination; D005260:Female; D005283:Fentanyl / Q000627:therapeutic use; D006403:Hematologic Tests; D017583:Hemodiafiltration; D006439:Hemodynamics; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D015742:Propofol / Q000008:administration & dosage* / Q000493:pharmacokinetics; D011446:Prospective Studies; D014280:Triglycerides / Q000097:blood
D014280:Triglycerides; D005283:Fentanyl; D015742:Propofol