Jm. Eddleston et al., THE USE OF PROPOFOL FOR SEDATION OF CRITICALLY ILL PATIENTS UNDERGOING HEMODIAFILTRATION, Intensive care medicine, 21(4), 1995, pp. 342-347
Objective: To assess the requirement for propofol to provide sedation
in critically ill patients in established renal failure during the com
mencement of haemodiafiltration. Design: Prospective clinical study. S
etting: ICU, University Hospital. Patients: 10 adult patients. All wer
e mechanically ventilated, had acute oliguric renal failure which nece
ssitated continuous veno-venous haemodiafiltration and were receiving
a continuous intravenous infusion of propofol for sedation. Sedation w
as assessed using a scoring system. Intervention: Veno-venous haemodia
filtration. Measurements and results: Connection of the extracorporeal
circuit produced a reduction in plasma propofol concentration in 7 ou
t of 9 patients (one sample misplaced) with subsequent awakening in 3
of these 7 patients. The commencement of haemodiafiltration itself did
not significantly influence the requirement for propofol (8 out of 10
patients). Conclusion: Haemodiafiltration does not substantially infl
uence the requirement for propofol but the initial introduction of the
extracorporeal circuit will reduce plasma concentrations in the major
ity of patients. This may be due to haemodilution alone or absorption
of plasma albumin (with propofol) onto the membrane.