Clinical evaluation of propofol as sedative for endotracheal intubation in neonates. (27th August 2013)

• Record Type: Journal Article
• Authors: Simons, SHP; van der, R; Reiss, Irwin KM; van, MM
• Is Part Of: Acta pædiatrica. Volume 102:Number 11(2013:Nov.)
• Page Start: e487
• Page End: e492
• Publication Date: 2013-08-27
• Subjects: Pediatrics -- Periodicals; Pediatrics; 618.92
• DOI: 10.1111/apa.12367
• Languages: English
• ISSNs: 0803-5253

Abstract

<abstract abstract-type="main" id="apa12367-abs-0001"> <title>Abstract</title> <sec id="apa12367-sec-0001" sec-type="section"> <title>Aim</title> <p>To determine the effects of propofol for endotracheal intubation in neonates in daily clinical practice.</p> </sec> <sec id="apa12367-sec-0002" sec-type="section"> <title>Methods</title> <p>We prospectively studied the pharmacodynamic effects of intravenous propofol administration in neonates who needed endotracheal intubation at the neonatal intensive care unit.</p> </sec> <sec id="apa12367-sec-0003" sec-type="section"> <title>Results</title> <p>Propofol was used for 62 intubations in neonates with postmenstrual ages ranging from 24 + 3 weeks to 44 + 5 weeks and bodyweights ranging from 520 to 4380 g. A 2 mg/kg bodyweight propofol starting dose was sufficient in 37% of patients; additional propofol was needed less often on the first postnatal day. The mean amount of propofol used was 3.3 (±1.2) mg/kg. The success rate of intubation depended on the experience of the physician and was related to the total administered amount of propofol. Hypotension occurred in 39% of patients and occurred more often at the first postnatal day. In 15% of procedures, propofol mono therapy was insufficient.</p> </sec> <sec id="apa12367-sec-0004" sec-type="section"> <title>Conclusion</title> <p>This study shows that high doses of propofol are needed to reach effective sedation in neonates for intubation, with hypotension as a side effect in a considerable percentage of patients. Further research in newborn patients needs to identify optimal propofol doses and risk factors for hypotension.</p> </sec> </abstract>