Continuous propofol infusion in 142 critically ill children.
OBJECTIVE
In recent years, continuous intravenous propofol infusion has been widely used in pediatric intensive care units. Several case reports have raised concerns about its safety. The objective of this study was to report our experience with continuous intravenous propofol in consecutive patients during an 18-month period.


METHODS
The study design was a retrospective review of a case series. Case was defined as a critically ill child who was treated with continuous intravenous propofol. The attending physician staff agreed to prescribe propofol via continuous intravenous infusion at a dose not to exceed 50 microg/kg/min. The protocol allowed for each patient to receive an additional intravenous bolus of propofol at a dose of 1 mg/kg no more than once per hour. The study entailed data collection from consecutive patients who were prescribed a continuous infusion of propofol in either the pediatric intensive care unit or bone marrow transplant unit.


RESULTS
Data from 142 patients were analyzed. Each patient enrolled was adequately sedated. Administration of propofol via continuous intravenous infusion was not associated with metabolic acidosis or hemodynamic compromise. No patient in the study group was inadvertently extubated or had a central venous catheter accidentally discontinued.


CONCLUSIONS
Propofol can be safely and effectively used to provide sedation to critically ill infants and children. We speculate that continuous infusion of propofol for extended periods of time should not exceed 67 microg/kg/min.
Cornfield
David N
DN
Department of Pediatrics, Oregon Health and Sciences University, Portland, Oregon, USA. cornf001@umn.edu
Tegtmeyer
Ken
K
Nelson
Michael D
MD
Milla
Carlos E
CE
Sweeney
Michael
M
D000138:Acidosis / Q000453:epidemiology; D000293:Adolescent; D000700:Analgesics / Q000008:administration & dosage; D002317:Cardiovascular Agents / Q000008:administration & dosage; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D016638:Critical Illness / Q000453:epidemiology; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage* / Q000009:adverse effects*; D007223:Infant; D007262:Infusions, Intravenous; D008991:Monitoring, Physiologic; D015742:Propofol / Q000008:administration & dosage* / Q000009:adverse effects*; D012189:Retrospective Studies
D000700:Analgesics; D002317:Cardiovascular Agents; D006993:Hypnotics and Sedatives; D015742:Propofol