Elsevier

The Lancet

Volume 357, Issue 9250, 13 January 2001, Pages 117-118
The Lancet

Fast track — Research Letters
Long-term propofol infusion and cardiac failure in adult head-injured patients

https://doi.org/10.1016/S0140-6736(00)03547-9Get rights and content

Summary

Five adult patients with head injuries inexplicably had fatal cardiac arrests in our neurosurgical intensive-care unit after the introduction of a sedation formulation containing an increased concentration of propofol. To examine the possible relation further, we did a retrospective cohort analysis of head-injured adults admitted to our unit between 1996 and 1999 who were sedated and mechanically ventilated. 67 patients met the inclusion criteria, of whom seven were judged to have died from propofol-infusion syndrome. The odds ratio for the occurrence of the syndrome was 1·93 (95% CI 1·12–3·32, p=0·018) for every mg/kg per h increase in mean propofol dose above 5 mg/kg per h. We suggest that propofol infusion at rates higher than 5 mg/kg per h should be discouraged for long-term sedation in the intensive-care unit.

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