Pediatric metabolism after propofol infusion in a pediatric intensive care unit

[SUMMARY] Background : Propofol infusion syndrome（PRIS） is characterized by lactic acidosis, rhabdomyolysis, and circulatory collapse after several days of high-dose propofol infusion. PRIS typically affects young and critically ill patients and is a potentially fatal cardiovascular and metabolic condition. On the contrary, short period intravenous drip and intermittent intravenous administration of propofol are commonplace in the operating theatre, however, there are no biochemical data indicating the safety of these settings in Japanese children. Methods : Thirty consecutive children who were admitted to the pediatric intensive care unit（PICU）after elective neurosurgical surgery and anesthetized by propofol infusion were enrolled. The total dosage and average speed of propofol infusion during the operation was calculated. The serum lactate level, blood gas analysis including the pH, icarbonate, base excess, and electrolytes were assessed postoperatively. Results : The total dosage of propofol administered during surgery was 53.8（37.4-71.1） mg/kg. The average speed of Propofol infusion administered during surgery was 9.9（8.6-11.9） mg/kg/hr. No case of PRIS or mortality occurred among these patients. All the patients had normal serum lactate and potassium levels. The blood gas pH was normal in most samples, but the bicarbonate and base excess were slightly low. However, there was no statistically significant difference in the total dose or average speed of propofol administration except for the lower bicarbonate level related to the higher average infusion speed of propofol. Conclusion : Our observational study revealed that the maximum mean rate of 9.9 mg/kg/hr and a total dosage of 53.8 mg/kg did not induce PRIS or death, did not elevate the serum lactate or potassium level, and slightly decreased the blood gas pH. The base excess was unaffected by the propofol dosage/speed of infusion. More data are required to establish the safety parameters for propofol administration and guidelines for propofol use in Japanese children.

https://opac.ll.chiba-u.jp/da/curator/105895/

https://opac.ll.chiba-u.jp/da/curator/105895/S03035476-95E-1-P1.pdf

The Chiba Medical Society

千葉医学会

学術雑誌論文

AN00142148

Chiba medical journal

95E

1

1

5

2019-02-10

10.20776/S03035476-95E-1-P1

publisher

Chiba Medical Journal (ONLINE ISSN 2433-4235)