Continuous propofol perfusion in critically ill children

Abstract

ObjectiveTo describe sedation with continuous perfusion of propofol in critically ill children. DesignA retrospective, descriptive observational study was carried out. SettingA pediatric Intensive Care Unit. PatientsPediatric patients requiring sedoanalgesia between October 1, 2009 and September 30, 2010. InterventionsNone. Data collectedDemographic, clinical and laboratory test variables, diagnosis, treatment, complications and evolution in each patient. In addition, the potential adverse effects associated with propofol administration were analyzed. ResultsMidazolam, fentanyl and propofol were the most commonly used sedative and analgesic drugs. Seventy-one out of 222 patients (32%) received propofol in continuous infusion. The average dose was 2.1mg/kg/h (SD 1.3, range: 0.5–6), and the average duration of treatment was of 6.7 days (SD 8.5 range 0.5–40). Fifty-two percent were male, and the mean patient age was 45.8 months (median: 24; interquartile range: 7–65). No patient developed propofol infusion syndrome or other serious drug-related adverse effects. Patients treated with propofol showed more abnormal laboratory test findings, although no relationship to drug administration could be demonstrated. There were no significant differences in lactate level or in the incidence of infection in either group. ConclusionsPropofol at a dose of 1–4mg/kg/h is a safe alternative for sustained sedation in critically ill children. However, further studies are needed to assess its effects and safety profile.