Propofol‐Related Infusion Syndrome in Intensive Care Patients

Corbett, Stephanie Mallow; Montoya, Isaac D.; Moore, Frederick A.

doi:10.1592/phco.28.2.250

Cited by 59 publications

(36 citation statements)

References 66 publications

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“…However, it has been associated with a number of serious adverse effects which are referred to by the term "propofol infusion syndrome" (Corbett et al, 2008;Blum and Brunsvold, 2009). The side-effects of propofol seem to be dose-and duration-related (Blum and Brunsvold, 2009).…”

Section: Discussionmentioning

confidence: 99%

Attenuating sevoflurane-induced cellular injury of human peripheral lymphocytes by propofol in a concentration-dependent manner

Zhou

et al. 2011

Arch. Pharm. Res.

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Sevoflurane, one of the most commonly used inhalation anesthetics, induces apoptosis and oxidative stress in lymphocytes. Propofol, an intravenous anesthetic, exhibits antiapoptotic and antioxidative activities. Therefore, the present study aimed to investigate whether propofol attenuates sevoflurane-induced cellular injury in human peripheral lymphocytes. Lymphocytes harvested from healthy volunteers were assigned to treatments with different concentrations of propofol, or 8% sevoflurane, or their combination. Propofol at concentrations of 5, 10 or 25 μg/mL had little effect, but 50 μg/mL propofol or 8% sevoflurane significantly reduced cell viability and mitochondrial membrane potential (ΔΦm), and increased cell apoptosis, activation of caspase-3 and the production of intracellular reactive oxygen species, compared with untreated cells. Five and ten μg/mL propofol attenuated the impact of sevoflurane on cell viability, apoptosis and ΔΦm, and 5, 10 and 25 μg/mL propofol inhibited the production of intracellular reactive oxygen species stimulated by sevoflurane. However, a combination of 50 μg/mL propofol and 8% sevoflurane led to more severe cellular injury than sevoflurane alone. The results suggest that propofol can attenuate sevoflurane-induced cellular injury of human peripheral lymphocytes in a concentration-dependent manner, providing a rational for the clinical use of sevoflurane combined with appropriate doses of propofol.

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Section: Discussionmentioning

confidence: 99%

Attenuating sevoflurane-induced cellular injury of human peripheral lymphocytes by propofol in a concentration-dependent manner

Zhou

et al. 2011

Arch. Pharm. Res.

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“…The remaining 40 are multipurpose and 14 of them have a cardiovascular recovery unit. The median number of PICU beds is 8 (6)(7)(8)(9)(10)(11)(12).…”

Section: Resultsmentioning

confidence: 99%

“…10,11 Until 2008, 33 pediatric cases were reported, 12 with a survival rate of 36%. In 29% of the PICUs in our study propofol is occasionally used.…”

Section: -9mentioning

confidence: 99%

Sedation and analgesia in patients on mechanical ventilation in pediatric intensive care units in Argentina

Taffarel

Bonetto

Barón

et al. 2018

Arch Argent Pediatr

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Introduction. Children in pediatric intensive care units (PICUs) are exposed to experiencing pain, stress and anxiety due to their disease, treatment or care setting. Adequate sedation and analgesia are key to their care, particularly in patients requiring mechanical ventilation (MV). Objective. To determine the usual practice in sedation and analgesia management in patients requiring MV in PICUs in Argentina. Material and methods. Descriptive, crosssectional, multi-center study conducted by means of e-mailed surveys. Results. A total of 45 PICUs were surveyed, 18% (N= 8) of which follow a sedation and analgesia protocol strictly, while 58% (N= 26) follow an "implied" protocol based on routine practice. The most commonly used drugs were midazolam, for sedation, and fentanyl, for analgesia. In 31% (N= 14) of the PICUs, sedation was monitored through assessment scales (modified Ramsay and/or Comfort scales). In 4% (N= 2) of units, daily, scheduled interruptions of sedation was implemented. In patients who are difficult to sedate, dexmedetomidine was the most commonly used adjuvant. In 73% (N= 33) of the units, neuromuscular blocking agents were used in compliance with precise guidelines and under clinical monitoring. In 20% (N= 9) of the PICUs there was a sedation and analgesia weaning protocol in place, and morphine and lorazepam are the most commonly used drugs. Conclusion. Only a low percentage of surveyed PICUs had a protocol in place for the routine management of sedation and analgesia in patients on MV.

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“…Propofol è noto soprattutto per la sua rapida comparsa di sedazione e la rapida eliminazione quando interrotto. Tuttavia, ha diversi effetti avversi noti quali ipotensione, depressione respiratoria, pancreatite e la cosiddetta sindrome da infusione [23]. Propofol è disponibile in una emulsione lipidica per infusione.…”

Section: Dexmedetomidina Nella Sedazione Dei Pazienti In Unità DI Terunclassified

The use of dexmedetomidine in intensive care sedation

Antonelli

Conti

Belisari³

et al. 2013

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The goals and recommendations for ICU (Intensive Care Unit) patients’ sedation and analgesia should be to have adequately sedated patients who are calm and arousal, so that they can guarantee a proper evaluation and an adequate control of pain. This way, it is also possible to perform their neurological evaluation, preserving intellectual faculties and helping them in actively participating to their care. Dexmedetomidine is a selective alpha-2 receptor agonist, member of theraputical cathegory: “other hypnotics and sedatives” (ATC: N05CM18). Dexmedetomidine is recommended for the sedation of adult ICU patients who need a sedation level not deeper than arousal in response to verbal stimulation (corresponding to Richmond Agitation-Sedation Scale 0 to -3). After the EMA approval, some European government authorities have elaborated HTA on dexmedetomidine, based on clinical evidence derived from Prodex and Midex trials. Dexmedetomidine resulted to be as effective as propofol and midazolam in maintaining the target depth of sedation in ICU patients. The mean duration of mechanical ventilation with dexmedetomidine was numerically shorter than with propofol and significantly shorter than with midazolam. The resulting favourable economic profile of dexmedetomidine supported the clinical use in ICU. Dexmedetomidine seems to provide clinical benefits due to the reduction of mechanical ventilation and ventilator weaning duration. Within the present review, an economic analysis of costs associated to the use of dexmedetomidine was therefore performed also in the Italian care setting. Thus, four different analyses were carried out based on the quantification of the total number of days in ICU, the time spent on mechanical ventilation, the weighted average number of days with mechanical ventilation or not and TISS points (Therapeutic Intervention Scoring System). Despite the incremental cost for drug therapy associated with dexmedetomidine, a reduction of the management costs for ICU has been estimated, with savings ranging between € 800 and € 1,400 per patient.

http://dx.doi.org/10.7175/fe.v14i1S.674

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Propofol‐Related Infusion Syndrome in Intensive Care Patients

Cited by 59 publications

References 66 publications

Attenuating sevoflurane-induced cellular injury of human peripheral lymphocytes by propofol in a concentration-dependent manner

Attenuating sevoflurane-induced cellular injury of human peripheral lymphocytes by propofol in a concentration-dependent manner

Sedation and analgesia in patients on mechanical ventilation in pediatric intensive care units in Argentina

The use of dexmedetomidine in intensive care sedation

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