Haemodynamic and oxygen transport effects of propofol infusion in critically ill adults

The effects of a sedative infusion of propofol on haemodynamics and oxygen transport were examined in critically ill adult patients. Ten patients receiving mechanical ventilation for treatment of septic shock and respiratory failure were given a decreasing rate propofol infusion designed to achieve and maintain a stable sedation level. Full cardiovascular and oxygen transport variables, arterial blood lactate concentrations and sedation scores were measured before infusion and at 1, 3 and 6 h after starting the infusion. There were significant reductions in mean (SEM) heart rate (97.3 (2.9) to 85.7 (3.9) beat.min-1 p < 0.05), mean arterial pressure (87.6 (3.7) to 76.2 (4.1) mmHg P < 0.05) and systemic vascular resistance index (1461 (137) to 1327 (141) dyne.s.cm-5.m-2 p < 0.05), with no significant change in cardiac filling pressures. There were no significant changes in cardiac output, oxygen delivery, oxygen consumption or arterial blood lactate concentrations. Controlled propofol sedation is well tolerated in appropriately monitored and resuscitated critically ill adult patients, and appears to have no major effects on whole-body oxygen transport.