[Long-term therapy with propofol has no impact on microcirculation in medical intensive care patients].

BACKGROUND

Microcirculation has become a major focus of research in critical care medicine due to its growing clinical relevance detecting changes in organ perfusion at an early stage. A negative impact of propofol infusion on microcirculation during short-term anesthesia was described recently. The influence of long-term sedation with propofol on microflow of critical care patients is still unclear.

PATIENTS AND METHODS

Microflow was analyzed using sidestream darkfield microscopy of sublingual mucosa in 28 patients of whom eleven received continuous infusion of propofol. According to current guidelines, microflow was recorded digitally. Quantitative analysis was performed offline in a semiquantitative way (0: no flow; 1: intermittent flow; 2: sluggish flow; 3: continuous flow).

RESULTS

Good microflow rates were detected in sublingual vessels (10-100 microm) in hemodynamically stable, medical intensive care patients. In the majority of cases, continuous flow profiles were recorded. There was no difference in flow rates between patients with and without propofol therapy.

CONCLUSION

In hemodynamically stable intensive care patients, long-term therapy with propofol did not affect sublingual microflow in this small cohort. However, intensive care physicians should keep such possible interactions in mind avoiding administration of these substances in patients with manifested shock. The effects of propofol in hemodynamically impaired patients should be evaluated in further studies.