Hiromi Koriyama1, Jonathan P Duff, Gonzalo Garcia Guerra, Alice W Chan. 1. 1Pharmacy Services, Covenant Health, Edmonton, AB, Canada. 2Misericordia Community Hospital, Edmonton, AB, Canada. 3Department of Pediatrics, University of Alberta, Edmonton, AB, Canada. 4Division of Pediatric Critical Care, Stollery Children's Hospital, Edmonton, AB, Canada. 5Pharmacy Services, Alberta Health Services-Edmonton and Area, Edmonton, AB, Canada. 6University of Alberta Hospital, Edmonton, AB, Canada.
Abstract
OBJECTIVE: The primary objective is to describe the practice patterns of nonprocedural propofol use in a single-center referral PICU. The secondary objective is to describe the rate of concordance of propofol use with the PICU local practice of a maximum mean rate of 4 mg/kg/hr and a maximum duration of 24 hours and to assess for signs and symptoms of propofol infusion syndrome. DESIGN: Retrospective descriptive cohort study. SETTING: PICU of a tertiary care teaching hospital and referral hospital for the Western Canada. PATIENTS: Children 1 month to 17 years old who received a nonprocedural propofol infusion between January 1, 2009, and December 31, 2009. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Two hundred twenty-three infusions (representing 210 unique patients) were included in the study. The median average infusion rate (interquartile range) including boluses was 2.7 mg/kg/hr (1.9-3.6 mg/kg/hr), and the mean infusion duration (SD) was 10.3 hours (6.7 hr). Eighty-seven percent and 98% of infusions were concordant with PICU intensivists self-reported practice maximum rate and duration, respectively. No cases of propofol-related infusion syndrome or deaths associated with propofol infusions were identified. CONCLUSIONS: The use of propofol infusions was in concordance with PICU local practice, and propofol infusion syndrome did not developed in patients. In agreement with previous recommendations, propofol infusions in the PICU appear to be safe when limiting doses to 4 mg/kg/hr and for less than 24 hours; however, appropriate monitoring of adverse effects is still warranted due to absence of robust evidence.
OBJECTIVE: The primary objective is to describe the practice patterns of nonprocedural propofol use in a single-center referral PICU. The secondary objective is to describe the rate of concordance of propofol use with the PICU local practice of a maximum mean rate of 4 mg/kg/hr and a maximum duration of 24 hours and to assess for signs and symptoms of propofol infusion syndrome. DESIGN: Retrospective descriptive cohort study. SETTING: PICU of a tertiary care teaching hospital and referral hospital for the Western Canada. PATIENTS: Children 1 month to 17 years old who received a nonprocedural propofol infusion between January 1, 2009, and December 31, 2009. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Two hundred twenty-three infusions (representing 210 unique patients) were included in the study. The median average infusion rate (interquartile range) including boluses was 2.7 mg/kg/hr (1.9-3.6 mg/kg/hr), and the mean infusion duration (SD) was 10.3 hours (6.7 hr). Eighty-seven percent and 98% of infusions were concordant with PICU intensivists self-reported practice maximum rate and duration, respectively. No cases of propofol-related infusion syndrome or deaths associated with propofol infusions were identified. CONCLUSIONS: The use of propofol infusions was in concordance with PICU local practice, and propofol infusion syndrome did not developed in patients. In agreement with previous recommendations, propofol infusions in the PICU appear to be safe when limiting doses to 4 mg/kg/hr and for less than 24 hours; however, appropriate monitoring of adverse effects is still warranted due to absence of robust evidence.
Authors: Roberta Esteves Vieira de Castro; Miguel Rodríguez-Rubio; Maria Clara de Magalhães-Barbosa; Arnaldo Prata-Barbosa; Jaimee Holbrook; Pradip Kamat; Anne Stormorken Journal: Front Pediatr Date: 2022-08-30 Impact factor: 3.569