1. The Safety of Continuous Infusion Propofol in Mechanically Ventilated Adults With Coronavirus Disease 2019
- Author
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Corey J. Witenko, Audrey J. Littlefield, Sajjad Abedian, Anjile An, Philip S. Barie, and Karen Berger
- Subjects
Adult ,adverse drug reactions ,SARS-CoV-2 ,sedatives ,respiratory failure ,COVID-19 ,Research Reports ,030208 emergency & critical care medicine ,Respiration, Artificial ,critical care ,Intensive Care Units ,03 medical and health sciences ,0302 clinical medicine ,Pancreatitis ,Acute Disease ,Humans ,Pharmacology (medical) ,030212 general & internal medicine ,Propofol ,Retrospective Studies - Abstract
Background: Propofol is commonly used to achieve ventilator synchrony in critically ill patients with coronavirus disease 2019 (COVID-19), yet its safety in this patient population is unknown. Objective: To evaluate the safety, in particular the incidence of hypertriglyceridemia, of continuous infusion propofol in patients with COVID-19. Methods: This was a retrospective study at 1 academic medical center and 1 affiliated teaching hospital in New York City. Adult, critically ill patients with COVID-19 who received continuous infusion propofol were included. Patients who received propofol for Results: A total of 252 patients were included. Hypertriglyceridemia (serum triglyceride concentration ≥ 400 mg/dL) occurred in 38.9% of patients after a median cumulative dose of 4307 mg (interquartile range [IQR], 2448-9431 mg). The median time to triglyceride elevation was 3.8 days (IQR, 1.9-9.1 days). In the multivariable regression analysis, obese patients had a significantly greater odds of hypertriglyceridemia (odds ratio = 1.87; 95% CI = 1.10, 3.21). There was no occurrence of acute pancreatitis. The incidence of possible propofol-related infusion syndrome was 3.2%. Conclusion and Relevance: Hypertriglyceridemia occurred frequently in patients with COVID-19 who received propofol but did not lead to acute pancreatitis. Elevated triglyceride concentrations occurred more often and at lower cumulative doses than previously reported in patients without COVID-19. Application of these data may aid in optimal monitoring for serious adverse effects of propofol in patients with COVID-19.
- Published
- 2021
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