METABOLIC, BIOCHEMICAL AND HEMODYNAMIC-EFFECTS OF INFUSION OF PROPOFOL FOR LONG-TERM SEDATION OF CHILDREN UNDERGOING INTENSIVE-CARE

We have studied prospectively, in nine children requiring sedation to facilitate mechanical ventilation, the metabolic, biochemical and haem odynamic effects of infusion of propofol. Children were given infusion s of propofol 1-4 mg kg(-1) h(-1) and fentanyl 1-5 mu g kg(-1) h(-1) f or 48 h. Heart rate, arteriai pressure, central venous pressure, fluid balance and urine output were recorded hourly and sedation scores eve ry 4 h. In addition to routine haemodynamic and biochemical measuremen ts in the intensive care, 6-hourly arterial blood-gas analysis and 12- hourly measurements of serum concentrations of glucose, lactate and el ectrolytes, renal function, triglycerides and liver function tests wer e performed. Urine was analysed for ketones. There were no significant differences in haemodynamic or biochemical variables during the 48-h period. In this small sample of children, propofol combined with fenta nyl provided excellent sedation with no evidence of cardiac, renal or hepatic impairment. Under these very proscriptive conditions we did no t encounter lipaemia or acidosis with infusion of propofol. Thus propo fol may be a safe sedative agent for use in paediatric intensive care if used appropriately. Further large scale studies are needed to deter mine if warnings against the use of this agent in paediatric intensive care units are justified.