WIP 40 - The Use of Continuous Propofol Infusion in a Pediatric Intensive Care Unit

Publication Number: WIP 40.7699

Oluwatomini A. Fashina, Mayo Clinic Children's Center, Rochester, MN, United States; Ashley V. Wong Grossman, Mayo Clinic, Rochester, MN, United States; Grace M. Arteaga, Mayo Clinic Children’s Center, Rochester, MN, United States; Sheri Crow, Mayo Clinic Children's Center, Rochester, MN, United States

Background: Historically, propofol has had limited use in pediatric critical care due to concerns of propofol-related infusion syndrome (PRIS). Reports have suggested that younger ages, higher doses, and longer durations are risk factors for the syndrome.

Objective: The objective of this study was to evaluate the relationship between propofol administration and characteristics of PRIS in a single medical/surgical Pediatric Intensive Care Unit (PICU). We hypothesized that a judicious continuous propofol infusion is not significantly associated with cardiovascular collapse, metabolic acidosis, or other clinical characteristics associated with PRIS, even when doses and duration of administration exceed the recommended ranges discussed in the current literature base.

Design/Methods: We performed a retrospective chart review of all patients aged 0-17 years old who were admitted to the medical/surgical Pediatric Intensive Care Unit from 1/1/2000 – 10/31/2024, and had received continuous propofol infusion > 12 hours. The study was approved by the Mayo Foundation for Medical Education and Research Institutional Review Board (IRB Number 16-00346). The legal guardians of all included patients had provided prior written consent for participation in research. The primary outcome measure was in-hospital mortality. The secondary outcome measures were intensive care unit (ICU) length of stay, bradycardia during infusion and variable heart rate during infusion. Outcome measures were compared in distributions of covariates across categorized age groups ( < 6 months, 6-12 months, 1-5 years, and 5-17 years) using chi-square/Fisher exact tests and Kruskal-Wallis tests where appropriate.