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Perioperative Continuous Propofol Infusion in the Pediatric Cardiac Intensive Care Unit: A 25-Year Retrospective
Oluwatomini A Fashina1, Grace M Arteaga2, Sheri S Crow2
1Department of Pediatrics, Mayo Clinic, Rochester, MN, USA. tominifashina@gmail.com.
Pediatric Cardiology
|December 6, 2025
Summary
In pediatric cardiac intensive care, continuous propofol infusion for sedation was studied. No cases of propofol-related infusion syndrome (PRIS) were observed in post-operative congenital heart disease patients.
Area of Science:
- Pediatric Critical Care Medicine
- Cardiology
- Anesthesiology
Background:
- Pediatric cardiac critical care necessitates tailored anesthesia and sedation due to unique patient vulnerabilities.
- Continuous propofol infusion is frequently used for sedation in Pediatric Cardiac Intensive Care Units (PCICUs).
- Propofol-related infusion syndrome (PRIS) is a rare but serious complication associated with propofol use.
Purpose of the Study:
- To assess the incidence of PRIS in post-operative congenital heart disease patients receiving continuous propofol infusions.
- To evaluate the safety profile of propofol in this specific high-risk pediatric population.
- To identify potential risk factors or associations with PRIS in PCICU patients.
Main Methods:
- Retrospective review of 641 post-operative congenital heart disease patients (<18 years) admitted to a PCICU.
- Inclusion criteria: continuous propofol infusion ≥12 hours and/or ≥2.4 mg/kg/hour.
- Analysis included PRIS incidence, ICU length of stay, survival, and stratification by physiological complexity and surgical risk scores.
Main Results:
- No cases of PRIS were reported in the study cohort.
- Median propofol infusion rate was 1.2 mg/kg/hour for a median duration of 22.7 hours.
- Survival to hospital discharge was 97%, with a median ICU length of stay of 7.1 days.
Conclusions:
- Continuous propofol infusion in post-operative congenital heart disease patients was not associated with PRIS in this single-center study.
- Findings support the cautious use of propofol for sedation in pediatric cardiac critical care.
- Further prospective research is recommended to confirm safety in diverse congenital heart disease populations, including single-ventricle physiology.
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