Carrie Ho1,2,3, Don Hayes1,4,2, Medhi Khosravi5, Mark L Splaingard1,2, Dmitry Tumin1,6, Eric A Lloyd7,8. 1. Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH, USA. 2. Section of Pulmonary Medicine, Nationwide Children's Hospital, Columbus, OH, USA. 3. Hospital of the University of Pennsylvania, Philadelphia, PA, USA. 4. Department of Internal Medicine, The Ohio State University College of Medicine, Columbus, OH, USA. 5. Department of Internal Medicine, University of Kentucky College of Medicine, Lexington, KY, USA. 6. Department of Anesthesiology & Pain Medicine, Nationwide Children's Hospital, Columbus, OH, USA. 7. Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH, USA. Eric.Lloyd@nationwidechildrens.org. 8. Section of Critical Care Medicine, Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH, 43205, USA. Eric.Lloyd@nationwidechildrens.org.
Abstract
INTRODUCTION: Flexible fiberoptic bronchoscopy (FFB) plays an important role in the surveillance of cystic fibrosis (CF) patients after lung transplantation (LTx). With rapid onset and clearance, propofol provides a safe and efficient method for sedation during FFB, yet sedation requirements for CF patients are not well described. OBJECTIVES: Due to pharmacokinetic differences for other classes of drugs in CF patients, this study was performed to examine propofol requirements for sedation during bronchoscopy in lung transplant recipients with CF. METHODS: A single-center retrospective cohort study was performed to examine propofol sedation requirements during outpatient surveillance. FFB procedures with transbronchial biopsy (TBB) in post-LTx recipients between 2009 and 2014 were conducted. RESULTS: A total of 40 FFB procedures with TBB were performed 20 CF (11 females), 20 non-CF (11 females). Mean (± SD) age was 25.6 ± 9.2 (range 13-42) years and 22.2 ± 10.8 (range 11-39) years for the CF and non-CF groups, respectively. Propofol requirements were significantly higher in the CF patients compared to the non-CF patients. Mean (± SD) propofol dose for CF patients was 334 ± 86 versus 214 ± 88 mg for non-CF patients (p < 0.001). Mean (± SD) propofol dose per weight (mg/kg) was 6.5 ± 2.1 for CF patients versus 3.8 ± 1.6 for non-CF patients (p < 0.001). CONCLUSIONS: Compared to a non-CF cohort, CF lung transplant recipients required higher dosages of propofol for sedation during FFB with TBB.
INTRODUCTION: Flexible fiberoptic bronchoscopy (FFB) plays an important role in the surveillance of cystic fibrosis (CF) patients after lung transplantation (LTx). With rapid onset and clearance, propofol provides a safe and efficient method for sedation during FFB, yet sedation requirements for CF patients are not well described. OBJECTIVES: Due to pharmacokinetic differences for other classes of drugs in CF patients, this study was performed to examine propofol requirements for sedation during bronchoscopy in lung transplant recipients with CF. METHODS: A single-center retrospective cohort study was performed to examine propofol sedation requirements during outpatient surveillance. FFB procedures with transbronchial biopsy (TBB) in post-LTx recipients between 2009 and 2014 were conducted. RESULTS: A total of 40 FFB procedures with TBB were performed 20 CF (11 females), 20 non-CF (11 females). Mean (± SD) age was 25.6 ± 9.2 (range 13-42) years and 22.2 ± 10.8 (range 11-39) years for the CF and non-CF groups, respectively. Propofol requirements were significantly higher in the CF patients compared to the non-CF patients. Mean (± SD) propofol dose for CF patients was 334 ± 86 versus 214 ± 88 mg for non-CF patients (p < 0.001). Mean (± SD) propofol dose per weight (mg/kg) was 6.5 ± 2.1 for CF patients versus 3.8 ± 1.6 for non-CF patients (p < 0.001). CONCLUSIONS: Compared to a non-CF cohort, CF lung transplant recipients required higher dosages of propofol for sedation during FFB with TBB.
Authors: T A O'Sullivan; J P Wang; J D Unadkat; S M al-Habet; W F Trager; A L Smith; S McNamara; M L Aitken Journal: Clin Pharmacol Ther Date: 1993-09 Impact factor: 6.875
Authors: Y Oda; N Hamaoka; T Hiroi; S Imaoka; I Hase; K Tanaka; Y Funae; T Ishizaki; A Asada Journal: Br J Clin Pharmacol Date: 2001-03 Impact factor: 4.335