ECMO-/ECLS

(Marcin) #1

  1. Propofol [13,17]^
    2,6 di-isopropylphenol, an alkylphenol IV general anesthetic
     Clinical indications: Use as sedative to facilitate short term
    mechanical ventilation and procedures
     Clinical effects: Dose-proportional sedative/anesthetic effects
    o Clinical effects dissipate quickly with discontinuation of
    infusion
    o Negative ionotropic effects
    o Potent vasodilator
     Dosing: initial bolus 1-2 mg/kg. Infusion 75-250 mcg/kg/minute
     Onset & elimination: Rapid onset – within a minute of
    injection.
    o 3 compartment pharmacokinetics – blood, rapidly
    equilibrating tissue (i.e. brain), slowly equilibrating
    tissue. Rapid distribution in blood & rapid clearance,
    which is responsible for short duration of action. Short
    distribution half life, long elimination half life.
     Precautions: Avoid use >12 hours in critically ill children
    o Risk of propofol infusion syndrome with prolonged use
    causes lactic acidosis, hyperlipidemia,
    bradyarrhythmias, myocardial failure & potential risk of
    death

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