Dl. Herr et al., Safety and efficacy of propofol with EDTA when used for sedation of surgical intensive care unit patients, INTEN CAR M, 26, 2000, pp. S452-S462
Objective: To compare propofol with disodium edetate (EDTA) and propofol wi
thout EDTA when used for the sedation of critically ill surgical intensive
care unit (ICU) patients.
Design: Prospective, randomised, multicentre trial.
Patients: A total of 122 surgical ICU patients who required intubation and
mechanical ventilation.
Interventions: Patients were randomised to receive either propofol or propo
fol plus EDTA (propofol EDTA) by continuous infusion for sedation.
Measurements and Results: The addition of EDTA to propofol had no effect on
calcium or magnesium homeostasis, renal function, haemodynamic function, o
r efficacy when used for the sedation of surgical patients in the ICU. The
most common adverse events were hypotension, atrial fibrillation, and hypoc
alcaemia. In this trial, a greater number of serious adverse events and adv
erse events leading to withdrawal occurred in the propofol group relative t
o the propofol EDTA group. There was a significantly lower crude mortality
rate at 7 and 28 days for the propofol EDTA group compared with the propofo
l group. There were no statistically significant differences between groups
with respect to depth of sedation.
Conclusion: The propofol EDTA formulation had no effect on calcium or magne
sium homeostasis, renal function, or sedation efficacy compared with propof
ol alone when used for sedation in critically ill surgical ICU patients. Th
ere was a significant decrease in mortality in the propofol EDTA group comp
ared with the propofol group. Further investigations are needed to validate
this survival benefit and elucidate a possible mechanism.