Modulating effects of propofol on metabolic and cardiopulmonary responses to stressful intensive care unit procedures.
OBJECTIVE
Patients in the intensive care unit (ICU) undergo acute increases in metabolic and cardiopulmonary demands in response to routine care interventions, such as chest physical therapy. This study examined whether the short-acting drug, propofol, could blunt the responses to chest physical therapy.


METHODS
Prospective, randomized, crossover (placebo vs. drug) study.


METHODS
University hospital surgical ICU.


METHODS
Postoperative ICU patients being ventilated in the synchronized intermittent mandatory ventilation mode.


METHODS
Two groups of 16 patients were studied. Each patient received two successive sessions of chest physical therapy. In random fashion, one was preceded by the administration of placebo and the other by an intravenous bolus of propofol (0.75 mg/kg in one group and 0.35 mg/kg in the other group). Each session was preceded and followed by a period of rest.


RESULTS
The increases in oxygen uptake, CO2 elimination, oxygen delivery, heart rate, and systolic blood pressure associated with chest physical therapy were attenuated with the low dose and suppressed with the high dose of propofol. The Paco2 concentration was slightly increased during both placebo and drug administration.


CONCLUSIONS
Propofol, in the doses administered in this study, significantly reduced the hemodynamic and metabolic stresses caused by chest physical therapy.
Cohen
D
D
Department of Anesthesiology, Columbia University, New York, NY 10032, USA.
Horiuchi
K
K
Kemper
M
M
Weissman
C
C
D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D003422:Critical Care / Q000379:methods* / Q000706:statistics & numerical data; D004305:Dose-Response Relationship, Drug; D005260:Female; D006321:Heart / Q000187:drug effects* / Q000503:physiopathology; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage*; D007385:Intermittent Positive-Pressure Ventilation; D008168:Lung / Q000187:drug effects* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D015742:Propofol / Q000008:administration & dosage*; D011446:Prospective Studies; D013312:Stress, Physiological / Q000097:blood / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology
D006993:Hypnotics and Sedatives; D015742:Propofol