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Propofol infusion syndrome in children
1Department of Anaesthesia, Royal Victoria Infirmary, Newcastle upon Tyne, UK.
Paediatric Anaesthesia
|December 4, 1998
Summary
Propofol infusions for pediatric sedation may be linked to myocardial failure. This study investigated serious adverse events in 18 children, finding a significant association with long-term, high-dose propofol use in pediatric intensive care units.
Area of Science:
- Pediatric Critical Care Medicine
- Clinical Pharmacology
- Anesthesiology
Background:
- Propofol infusions were widely used for pediatric sedation in intensive care units (ICUs).
- Reports of myocardial failure and deaths led to decreased propofol use.
- Concerns arose that propofol might have been prematurely condemned.
Purpose of the Study:
- To investigate serious adverse events associated with propofol infusions in children.
- To identify common features among children experiencing adverse effects.
- To assess the potential link between propofol administration and myocardial failure in a pediatric ICU setting.
Main Methods:
- Retrospective review of 18 pediatric patients who received propofol infusions and experienced serious adverse effects.
- Analysis of data from a specific ICU between 1987 and 1993.
- Statistical analysis (Fisher's Exact Test) to determine the association between propofol dosage/duration and myocardial failure.
Main Results:
- Three deaths from progressive myocardial failure occurred in a single ICU among children receiving long-term (>48h), high-dose (>4 mg.kg-1.h-1) propofol infusions.
- Nine children received such infusions during the study period.
- A significant association (P=0.0128) was found between long-term, high-dose propofol infusions and progressive myocardial failure.
Conclusions:
- While a causative relationship could not be definitively proven, a significant association exists between long-term, high-dose propofol infusions and progressive myocardial failure in pediatric patients.
- These findings warrant careful consideration of propofol administration protocols in pediatric ICUs.
- Further research may be needed to elucidate the mechanisms and confirm causality.
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