Related Experiment Videos

Propofol associated with a shorter duration of mechanical ventilation than scheduled intermittent lorazepam: a

Jeffrey J Fong1, Salmaan Kanji, Joseph F Dasta

  • 1School of Pharmacy, Northeastern University, Boston, MA 02115, USA.

The Annals of Pharmacotherapy
|October 25, 2007
PubMed
Abstract

Insights

Propofol sedation is linked to shorter mechanical ventilation durations than lorazepam in intensive care units (ICUs). This finding applies to both medical and surgical ICU patients, supporting earlier research.

Area of Science:

  • Critical Care Medicine
  • Pharmacology
  • Intensive Care Unit (ICU) Management

Background:

  • Previous studies suggested propofol reduces mechanical ventilation duration in medical ICUs.
  • The applicability of these findings to surgical ICUs and different sedation protocols remained unclear.

Purpose of the Study:

  • To compare mechanical ventilation duration in medical and surgical ICU patients receiving either propofol or scheduled intermittent lorazepam.
  • To evaluate sedative choice impact in routine clinical practice.

Main Methods:

  • Retrospective analysis of the Project IMPACT database (2001-2005).
  • Included medical and surgical ICU patients on mechanical ventilation for ≥24 hours and receiving propofol or lorazepam for ≥24 hours.
  • Evaluated factors influencing ventilation duration, including sedative type.

Main Results:

  • Propofol use was associated with significantly shorter mechanical ventilation durations in both medical (6 vs. 11 days, p=0.03) and surgical ICUs (4 vs. 9 days, p=0.001).
  • Prolonged ventilation in medical ICUs linked to longer sedation, narcotic use, and lorazepam.
  • Prolonged ventilation in surgical ICUs linked to longer sedation, higher APACHE II scores, and lorazepam.

Conclusions:

  • Propofol sedation is associated with shorter mechanical ventilation durations compared to lorazepam in both medical and surgical ICUs.
  • Findings in a real-world setting align with previous randomized controlled trial results.

Related Concept Videos

Parenteral Anesthetics: Overview01:24

Parenteral Anesthetics: Overview

Intravenous anesthetics are drugs administered parenterally to induce anesthesia or sedation. Propofol is a widely used agent formulated as a 1% emulsion in soybean oil, glycerol, and egg phosphatide. It induces rapid anesthesia primarily due to its rapid distribution from the bloodstream to target tissues and is metabolized in the liver. However, it can cause significant pain on injection and hypertriglyceridemia. Fospropofol, a water-based prodrug of propofol, lacks these adverse effects.
General Anesthesia: Overview01:24

General Anesthesia: Overview

Anesthesia is a medical procedure that uses drugs for CNS suppression to enable painless surgeries and procedures. The selection of anesthetics is influenced by their pharmacokinetic properties, side effects, and patient characteristics. Various types of anesthesia include general, local, regional, spinal, and inhalational.
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...
Inhalational Anesthetics: Overview01:20

Inhalational Anesthetics: Overview

Inhalation anesthetics are drugs that induce general anesthesia upon inhalation. They work by increasing the sensitivity of GABAA receptors or inhibiting NMDA receptors, leading to a decrease in central nervous system activity. The depth of anesthesia can be rapidly adjusted by changing the concentration of the inhaled gas. Some common examples of inhalational anesthetics include volatile liquids like isoflurane, desflurane, sevoflurane and gases like xenon and nitrous oxide. Isoflurane, a...
Sedatives and Hypnotics Drugs: Barbiturates01:20

Sedatives and Hypnotics Drugs: Barbiturates

Sedatives and hypnotics encompass a drug class that acts on the central nervous system (CNS) to alleviate anxiety, promote relaxation and induce sleep.These drugs function by amplifying the actions of the neurotransmitter γ-aminobutyric acid (GABA), resulting in reduced neuronal activity. Barbiturates, a subset of sedatives and hypnotics first synthesized in the late 1800s, are categorized into ultra-short, short, intermediate, and long-acting groups based on their duration of effect. A key...
Sedatives and Hypnotics Drugs: Benzodiazepines01:19

Sedatives and Hypnotics Drugs: Benzodiazepines

Benzodiazepines have both sedative and hypnotic properties. They include compounds such as diazepam (Valium) and alprazolam (Xanax). Structurally, their cores are similar, consisting of the fusion of a benzene ring and a diazepine ring, but they share a common mechanism of action in the central nervous system (CNS).
Benzodiazepines work by enhancing the effects of the inhibitory neurotransmitter GABA. They bind to the GABAA receptor, increasing its affinity for GABA, which opens chloride...
Stages of General Anesthesia01:22

Stages of General Anesthesia

Various sedation levels offer significant advantages in facilitating procedural interventions for patients undergoing medical or invasive surgical procedures. These levels span from anxiolysis to general anesthesia, providing a spectrum of sedative effects to cater to specific patient needs. Anxiolysis reduces anxiety and is achieved through minimal sedation, enabling patients to remain awake and responsive while feeling more at ease during the procedure. This level can benefit minor...