Propofol as a bridge to extubation in the pediatric intensive care unit
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| Language: | English |
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University of Cincinnati / OhioLINK
2009
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| Online Access: | http://rave.ohiolink.edu/etdc/view?acc_num=ucin1243354898 |
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ndltd-OhioLink-oai-etd.ohiolink.edu-ucin12433548982021-08-03T06:13:23Z Propofol as a bridge to extubation in the pediatric intensive care unit Mack, Elizabeth H. Health Care Pharmaceuticals Pharmacology propofol sedation pediatric critical care mechanical ventilation <p><b>Objective:</b> A significant number of children require long-term sedation and mechanical ventilation, which leads to significant morbidity and mortality. Propofol use decreases time to extubation and extubation failure in adults. However, there are safety concerns with long-term use of propofol, particularly in children. The purpose of this study is to report the safety and efficacy of propofol used as a bridge to extubation in children who have received long-term mechanical ventilation and sedation.</p><p><b>Methods:</b> After querying the pharmacy database, charts were reviewed to screen for propofol infusion use in pediatric and cardiac intensive care units at a single large children's hospital. A total of 152 uses of propofol (representing 141 unique patients) were analyzed in this case series. We measured exposure to propofol by total dose, average dose, maximum dose, and duration of propofol use. We assessed safety of propofol use in this limited setting by evaluating the incidence of bradycardia, hypotension, acidosis, and mortality. Efficacy is measured by time to extubation and extubation success.</p><p><b>Results:</b> Median time to extubation was 30 minutes and the extubation failure rate was 20%. Bradycardia (42%) and hypotension (28%) are common, but typically self-limited. Inotrope requirement prior to initiation of propofol predicted hypotension and acidosis. There were no cases of propofol infusion syndrome.</p><p><b>Conclusions:</b> The short-term use of propofol as a bridge to extubation in pediatric patients after longterm ventilation is a safe and effective strategy if used in carefully selected hemodynamically stable patients.</p> 2009-08-04 English text University of Cincinnati / OhioLINK http://rave.ohiolink.edu/etdc/view?acc_num=ucin1243354898 http://rave.ohiolink.edu/etdc/view?acc_num=ucin1243354898 unrestricted This thesis or dissertation is protected by copyright: all rights reserved. It may not be copied or redistributed beyond the terms of applicable copyright laws. |
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NDLTD |
| language |
English |
| sources |
NDLTD |
| topic |
Health Care Pharmaceuticals Pharmacology propofol sedation pediatric critical care mechanical ventilation |
| spellingShingle |
Health Care Pharmaceuticals Pharmacology propofol sedation pediatric critical care mechanical ventilation Mack, Elizabeth H. Propofol as a bridge to extubation in the pediatric intensive care unit |
| author |
Mack, Elizabeth H. |
| author_facet |
Mack, Elizabeth H. |
| author_sort |
Mack, Elizabeth H. |
| title |
Propofol as a bridge to extubation in the pediatric intensive care unit |
| title_short |
Propofol as a bridge to extubation in the pediatric intensive care unit |
| title_full |
Propofol as a bridge to extubation in the pediatric intensive care unit |
| title_fullStr |
Propofol as a bridge to extubation in the pediatric intensive care unit |
| title_full_unstemmed |
Propofol as a bridge to extubation in the pediatric intensive care unit |
| title_sort |
propofol as a bridge to extubation in the pediatric intensive care unit |
| publisher |
University of Cincinnati / OhioLINK |
| publishDate |
2009 |
| url |
http://rave.ohiolink.edu/etdc/view?acc_num=ucin1243354898 |
| work_keys_str_mv |
AT mackelizabethh propofolasabridgetoextubationinthepediatricintensivecareunit |
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1719433007907995648 |