Parke T J, Stevens J E, Rice A S, Greenaway C L, Bray R J, Smith P J, Waldmann C S, Verghese C
Nuffield Department of Anaesthetics, John Radcliffe Hospital, Oxford.
BMJ. 1992 Sep 12;305(6854):613-6. doi: 10.1136/bmj.305.6854.613.
To examine the possible contribution of sedation with propofol in the deaths of children who were intubated and required intensive care.
Case note review.
Three intensive care units.
Five children with upper respiratory tract infections aged between 4 weeks and 6 years.
Four patients had laryngotracheo-bronchitis and one had bronchiolitis. All were sedated with propofol. The clinical course in all five cases was remarkably similar: an increasing metabolic acidosis was associated with brady-arrhythmia and progressive myocardial failure, which did not respond to resuscitative measures. All children developed lipaemic serum after starting propofol. These features are not usually associated with respiratory tract infections. No evidence was found of viral myocarditis, which was considered as a possible cause of death.
Although the exact cause of death in these children could not be defined, propofol may have been a contributing factor.
探讨丙泊酚镇静在接受气管插管并需要重症监护的儿童死亡中可能起到的作用。
病例记录回顾。
三个重症监护病房。
五名年龄在4周至6岁之间的上呼吸道感染儿童。
四名患者患有喉气管支气管炎，一名患有细支气管炎。所有患者均使用丙泊酚镇静。所有五例的临床病程非常相似：代谢性酸中毒加重伴缓慢性心律失常和进行性心肌衰竭，复苏措施对此无反应。所有儿童在开始使用丙泊酚后均出现脂血血清。这些特征通常与呼吸道感染无关。未发现病毒性心肌炎的证据，而病毒性心肌炎曾被认为是可能的死因。
尽管这些儿童的确切死因无法确定，但丙泊酚可能是一个促成因素。
