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PEDIATRICS Vol. 110 No. 6 December 2002, pp. 1177-1181

Continuous Propofol Infusion in 142 Critically Ill Children

David N. Cornfield, MD{ddagger}, Ken Tegtmeyer, MD*, Michael D. Nelson, MD{ddagger}, Carlos E. Milla, MD{ddagger} and Michael Sweeney, MD{ddagger},§

* Department of Pediatrics, Oregon Health and Sciences University, Portland, Oregon
{ddagger} Division of Pediatric Pulmonology and Critical Care Medicine
§ Departments of Pediatrics and Anesthesia, University of Minnesota, Minneapolis, Minnesota

--> Objective. In recent years, continuous intravenous propofol infusion has been widely used in pediatric intensive care units. Several case reports have raised concerns about its safety. The objective of this study was to report our experience with continuous intravenous propofol in consecutive patients during an 18-month period.

Methods. The study design was a retrospective review of a case series. Case was defined as a critically ill child who was treated with continuous intravenous propofol. The attending physician staff agreed to prescribe propofol via continuous intravenous infusion at a dose not to exceed 50 µg/kg/min. The protocol allowed for each patient to receive an additional intravenous bolus of propofol at a dose of 1 mg/kg no more than once per hour. The study entailed data collection from consecutive patients who were prescribed a continuous infusion of propofol in either the pediatric intensive care unit or bone marrow transplant unit.

Results. Data from 142 patients were analyzed. Each patient enrolled was adequately sedated. Administration of propofol via continuous intravenous infusion was not associated with metabolic acidosis or hemodynamic compromise. No patient in the study group was inadvertently extubated or had a central venous catheter accidentally discontinued.

Conclusions. Propofol can be safely and effectively used to provide sedation to critically ill infants and children. We speculate that continuous infusion of propofol for extended periods of time should not exceed 67 µg/kg/min.

Key Words: sedation • metabolic acidosis • mechanical ventilation

Abbreviations: PICU, pediatric intensive care unit • BMT, bone marrow transplantation • FDA, US Food and Drug Administration

Received for publication Feb 4, 2002; Accepted Jun 7, 2002.




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