title: Use of propofol in pediatric intensive care units: a national survey in Germany.
abstract: OBJECTIVE
  Propofol is not licensed for sedation in pediatric intensive care medicine mainly due to the risk of propofol infusion syndrome. Nevertheless, it is applied by many pediatric intensive care units. The aim of this national survey was to asses the current use of propofol in pediatric intensive care units in Germany.
  
  
  METHODS
  We performed a nationwide survey. The questionnaire assessed the intensive care unit type, patient numbers, dosing, duration, age and time limits, indications, side effects, and institutional protocols for propofol usage.
  
  
  METHODS
  Pediatric intensive care units in Germany.
  
  
  METHODS
  Questionnaire about routine use of propofol sent to 214 pediatric departments.
  
  
  METHODS
  None.
  
  
  RESULTS
  One hundred ninety-four questionnaires (90.7%) were returned, ten had to be censored. The final analysis comprised 184 questionnaires (134 pediatric/neonatal intensive care units, 28 pediatric intensive care units, 22 neonatal intensive care units). Seventy-nine percent of intensive care units (n = 145 of 184) used propofol in children under the age of 16 yrs. Of these, 98% were for bolus application (n = 142 of 145), 78% for infusion ≥3 hrs (n = 113 of 145), and 33% for infusion >3 hrs (n = 48 of 145). A lower age limit was applied by 52% (n = 75 of 145) and a dose limit by 51% (n = 74 of 145). The median dose limit was 4 mg/kg/hr; 48% (n = 70 of 145) used 3 mg/kg/hr or less. A time limit was applied by 98% (n = 46 of 47), 70% (n = 33 of 47) used it for ≤24 hrs, and 30% (n = 15 of 47) for >24 hrs. MAIN INDICATIONS FOR PROPOFOL APPLICATION WERE: difficult sedation (44%), postoperative ventilation (43%), and difficult extubation (30%). Seven cases of propofol infusion syndrome were reported by seven centers.
  
  
  CONCLUSIONS
  This study shows that propofol is used off-license by many pediatric intensive care units in Ge. The majority of users has adopted tightly controlled regimens for propofol sedation, and limits the dose to ≤3-4 mg/kg/hr and the maximum application time to 24-48 hrs.
authors.affiliation: Department of Anaesthesiology and Postoperative Intensive Care Medicine, University Hospital of Cologne, Cologne, Germany.
authors.forename: Markus A
authors.initials: MA
authors.lastname: Kruessell
authors.forename: Floris E A
authors.initials: FE
authors.lastname: Udink ten Cate
authors.forename: Anna-Julia
authors.initials: AJ
authors.lastname: Kraus
authors.forename: Bernhard
authors.initials: B
authors.lastname: Roth
authors.forename: Uwe
authors.initials: U
authors.lastname: Trieschmann
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004363:Drug Utilization / Q000706:statistics & numerical data*; D005858:Germany; D019538:Health Care Surveys; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage / Q000009:adverse effects; D007223:Infant; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal / Q000706:statistics & numerical data; D015278:Intensive Care Units, Pediatric / Q000706:statistics & numerical data*; D056687:Off-Label Use / Q000706:statistics & numerical data*; D015742:Propofol / Q000008:administration & dosage / Q000009:adverse effects; D011795:Surveys and Questionnaires
chemical_list: D006993:Hypnotics and Sedatives; D015742:Propofol