Pharmacokinetics of Propofol Infusions in Critically Ill Neonates, Infants, and Children in an Intensive Care Unit

Rigby-Jones, A. E.; Nolan, Judith A.; Priston, M. J.; Wright, P. M. C.; Sneyd, J. R.; Wolf, Andrew

doi:10.1097/00000542-200212000-00010

Cited by 112 publications

(63 citation statements)

References 21 publications

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“…Propofol (2,6-diisopropylphenol), an intravenous anesthetic, has been widely used for inducing and maintaining anesthesia (Rigby-Jones et al 2002). Apart from its multiple anesthetic advantages, propofol has been reported to have a number of nonanesthetic effects such as anti-oxidative and anti-inflammatory properties (Chikutei et al 2006;Wang et al 2009).…”

Section: Introductionmentioning

confidence: 99%

Propofol Protects Against H2O2-Induced Oxidative Injury in Differentiated PC12 Cells via Inhibition of Ca2+-Dependent NADPH Oxidase

et al. 2015

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Propofol (2,6-diisopropylphenol) is a widely used general anesthetic with anti-oxidant activities. This study aims to investigate protective capacity of propofol against hydrogen peroxide (H2O2)-induced oxidative injury in neural cells and whether the anti-oxidative effects of propofol occur through a mechanism involving the modulation of NADPH oxidase (NOX) in a manner of calcium-dependent. The rat differentiated PC12 cell was subjected to H2O2 exposure for 24 h to mimic a neuronal in vitro model of oxidative injury. Our data demonstrated that pretreatment of PC12 cells with propofol significantly reversed the H2O2-induced decrease in cell viability, prevented H2O2-induced morphological changes, and reduced the ratio of apoptotic cells. We further found that propofol attenuated the accumulation of malondialdehyde (biomarker of oxidative stress), counteracted the overexpression of NOX core subunit gp91(phox) (NOX2) as well as the NOX activity following H2O2 exposure in PC12 cells. In addition, blocking of L-type Ca(2+) channels with nimodipine reduced H2O2-induced overexpression of NOX2 and caspase-3 activation in PC12 cells. Moreover, NOX inhibitor apocynin alone or plus propofol neither induces a significant downregulation of NOX activity nor increases cell viability compared with propofol alone in the PC12 cells exposed to H2O2. These results demonstrate that the protective effects of propofol against oxidative injury in PC12 cells are mediated, at least in part, through inhibition of Ca(2+)-dependent NADPH oxidase.

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Section: Introductionmentioning

confidence: 99%

Propofol Protects Against H2O2-Induced Oxidative Injury in Differentiated PC12 Cells via Inhibition of Ca2+-Dependent NADPH Oxidase

et al. 2015

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“…Extubation time following discontinuation of the remifentanil and propofol infusion was only 24±20 min (5-80 min). Propofol is a popular anesthetic with a rapid onset and short duration of action [19,20]. Sheridan et al reported about short-term propofol infusion as an adjunct to extubation in children.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, we replaced their analgesic and sedative drugs at the final phase of the weaning process with remifentanil and propofol. As both substances have a short half-life, we hypothesized that they allow rapid awakening and safe extubation after discontinuation of the continuous infusion [19][20][21][22].…”

Section: Introductionmentioning

confidence: 99%

Remifentanil and propofol for weaning of mechanically ventilated pediatric intensive care patients

et al. 2010

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Mechanically ventilated pediatric intensive care patients usually receive an analgesic and sedative to keep them comfortable and safe. However, common drugs like fentanyl and midazolam have a long context sensitive half time, resulting in prolonged sedation and an unpredictable extubation time. Children often awake slowly and struggle against the respirator, although their respiratory drive and their airway reflexes are not yet sufficient for extubation. In this pilot study, we replaced fentanyl and midazolam at the final phase of the weaning process with remifentanil and propofol. Twenty-three children aged 3 months-10 years were enrolled. Remifentanil and propofol revealed throughout excellent or good weaning conditions with rapid transition from hypnosis to the development of regular spontaneous breathing, airway protective reflexes, and an appropriate level of alertness. Extubation time following discontinuation of the remifentanil and propofol infusion was only 24 ± 20 min (5-80 min). We conclude that the combination of remifentanil and propofol is a promising option to improve the weaning conditions of pediatric intensive care patients. Randomized controlled trials are needed to compare remifentanil and propofol with conventional weaning protocols.

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“…Nesse contexto de doses baixas a moderadas Sloan 12 chegou a referir que para procedimentos curtos em crianças com doenças mitocondriais musculares é mais seguro o uso do propofol do que dos agentes halogenados, barbitúricos e do óxido nitroso. Rigby-Jones e col. 13 , em seus estudos farmacocinéticos com crianças gravemente enfermas sugeriram como segura uma dose até 4 mg.kg -1 .h -1 , porém é importante lembrar que seus pacientes foram observados após a realização de procedimentos cirúrgicos cardíacos 14 .…”

Section: Propriedades Farmacocinéticas E Farmacodinâmicas Do Propofolunclassified

“…In this context of low to moderate doses, Sloan 12 reported that propofol is safer than halogenated agents, barbiturates, and nitrous oxide for short procedures in children with muscular mitochondrial disorders. In their pharmacokinetic studies in severely ill children, Rigby-Jones et al 13 suggested that doses of up to 4 mg.kg -1 .h -1 . are safe; but one should remember that their patients were observed after cardiac surgeries …”

Section: Pharmacokinetics and Pharmacodynamics Of Propofolmentioning

confidence: 99%

Síndrome da infusão do propofol

Barbosa¹

2007

Rev. Bras. Anestesiol.

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Rev Bras AnestesiolARTIGO DIVERSO 2007; 57: 5: 539-542 MISCELLANEOUS ARTICLE RESUMO Barbosa FT -Síndrome da Infusão do Propofol. JUSTIFICATIVA E OBJETIVOS:A síndrome da infusão do propofol tem sido descrita como uma síndrome rara e quase sempre fatal que ocorre após infusão prolongada desse fármaco. Ela pode resultar em acidose metabólica grave, rabdomiólise, colapso cardiovascular e morte. O objetivo deste artigo foi mostrar aspectos relacionados com a síndrome da infusão do propofol por meio da revisão de literatura. CONTEÚDO:Estão definidas as características da síndrome da infusão do propofol quanto à fisiopatologia, características clínicas, tratamento e recomendações de dose para pacientes gravemente enfermos. CONCLUSÕES:O propofol deve ser usado com cautela quando se planeja seu uso sob regime de infusão contínua por períodos prolongados. O surgimento de sinais sugestivos da síndrome da infusão do propofol indica a suspensão imediata do fármaco e iní-cio de medidas de suporte.Unitermos: ANESTÉSICO, Venoso, propofol; COMPLICAÇÕES: sín-drome da infusão do propofol. SUMMARYBarbosa FT -Propofol Infusion Syndrome. BACKGROUND AND OBJECTIVES:Propofol infusion syndrome has been described as a rare, and frequently fatal, syndrome that occurs after prolonged infusion of this drug. It might result in severe metabolic acidosis, rhabdomyolysis, cardiovascular failure, and death. The objective of this report was to review the literature to present aspects related to the propofol infusion syndrome. CONTENTS:The physiopathology, clinical characteristics, and treatment, of the propofol infusion syndrome as well as dose recommendations for severely ill patients are presented here. CONCLUSIONS:Propofol should be used with caution when it is administered as continuous infusion for prolonged periods of time.The development of signs suggestive of the propofol infusion syndrome indicates the drug should be discontinued immediately and support measures instituted.

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Pharmacokinetics of Propofol Infusions in Critically Ill Neonates, Infants, and Children in an Intensive Care Unit

Abstract: Propofol kinetics are altered in very small babies and in children recovering from cardiac surgery. Increased peripheral distribution volume and reduced metabolic clearance following surgery causes prolonged elimination.

Cited by 112 publications

References 21 publications

Propofol Protects Against H2O2-Induced Oxidative Injury in Differentiated PC12 Cells via Inhibition of Ca2+-Dependent NADPH Oxidase

Propofol Protects Against H2O2-Induced Oxidative Injury in Differentiated PC12 Cells via Inhibition of Ca2+-Dependent NADPH Oxidase

Remifentanil and propofol for weaning of mechanically ventilated pediatric intensive care patients

Síndrome da infusão do propofol

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