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Evaluation of Hypertriglyceridemia in Critically Ill Patients With Coronavirus Disease 2019 Receiving Propofol

Mary P Kovacevic1, Kevin M Dube1, Kenneth E Lupi1

  • 1Clinical Pharmacy Specialist, Department of Pharmacy, Brigham and Women's Hospital, Boston, MA.

Critical Care Explorations
|January 25, 2021
PubMed

Insights

Hypertriglyceridemia frequently developed in critically ill COVID-19 patients on propofol, but propofol dose or duration were not risk factors. Frequent triglyceride monitoring is recommended for patients on propofol for over 24 hours.

Area of Science:

  • Critical Care Medicine
  • Pharmacology
  • Infectious Diseases

Background:

  • Propofol is commonly used for sedation in intensive care units (ICUs).
  • Coronavirus disease 2019 (COVID-19) can lead to critical illness requiring prolonged ICU stays and sedation.
  • Hypertriglyceridemia is a potential adverse effect of propofol, particularly with prolonged use.

Purpose of the Study:

  • To determine the prevalence of hypertriglyceridemia in COVID-19 patients receiving propofol.
  • To identify risk factors associated with the development of hypertriglyceridemia in this population.
  • To evaluate the safety and management of propofol in COVID-19 patients who develop hypertriglyceridemia.

Main Methods:

  • Retrospective, observational study at a single tertiary academic medical center.
  • Included ICU patients with COVID-19 who received propofol between March 1, 2020, and April 20, 2020.
  • Analyzed patient data for the development of hypertriglyceridemia (serum triglyceride > 400 mg/dL), acute pancreatitis, and propofol metrics.

Main Results:

  • Of 106 patients, 56.6% developed hypertriglyceridemia, with a median onset of 46 hours.
  • No significant difference in propofol dose or duration was found between patients who did and did not develop hypertriglyceridemia.
  • Elevated inflammatory markers were observed in patients who developed hypertriglyceridemia; five patients had suspected acute pancreatitis.

Conclusions:

  • Hypertriglyceridemia is a common complication in critically ill COVID-19 patients treated with propofol.
  • Propofol dose and duration were not identified as risk factors for hypertriglyceridemia.
  • Frequent monitoring of serum triglyceride levels is advised for COVID-19 patients receiving propofol for over 24 hours; dose reduction allowed continued propofol use in many cases.
Abstract

Keywords:
acute respiratory distress syndromeanalgesia and sedationcoronavirus disease 2019lipidspancreatitispropofol

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