Hohlfelder Benjamin, Szumita Paul M, Lagambina Susan, Weinhouse Gerald, Degrado Jeremy R
From the *Department of Pharmacy Services, Brigham and Women's Hospital, Boston, Massachusetts; †Department of Respiratory Therapy, Brigham and Women's Hospital, Boston, Massachusetts; and ‡Department of Pulmonary Medicine, Brigham and Women's Hospital, Boston, Massachusetts.
ASAIO J. 2017 Mar/Apr;63(2):179-184. doi: 10.1097/MAT.0000000000000461.
The purpose of this analysis is to describe the safety of propofol administration in adult extracorporeal membrane oxygenation (ECMO) patients. We performed a prospective cohort analysis of patients using ECMO at Brigham and Women's Hospital between February 2013 and October 2015. Patients were included if they used ECMO for at least 48 hours. The major end-point of the analysis was the median oxygenator lifespan. Oxygenator exchanges were analyzed by the number of patients requiring an oxygenator exchange and the number of oxygenator exchanges per ECMO day. A priori analysis was performed by comparing the outcomes between patients who did and did not receive propofol during their ECMO course. During the study, 43 patients were included in the analysis. Sixteen patients used propofol during their ECMO course. There were 12 oxygenator exchanges during therapy. Oxygenator exchange occurred on 1.8% of ECMO days. The median oxygenator lifespan was 7 days. Patients who used propofol had a significantly longer oxygenator lifespan (p = 0.02). Among patients who received propofol, patients who required oxygenator exchange used a significantly lower median daily dose of propofol (p < 0.001). The use of propofol appears safe in ECMO with regards to oxygenator viability. Contrary to expected, oxygenator lifespan was significantly longer among patients who received propofol.
本分析的目的是描述丙泊酚在成人体外膜肺氧合(ECMO)患者中的用药安全性。我们对2013年2月至2015年10月期间在布莱根妇女医院使用ECMO的患者进行了一项前瞻性队列分析。若患者使用ECMO至少48小时则纳入研究。分析的主要终点是氧合器的中位使用寿命。通过需要更换氧合器的患者数量以及每ECMO日的氧合器更换数量来分析氧合器的更换情况。通过比较在ECMO治疗过程中接受和未接受丙泊酚治疗的患者的结局进行先验分析。在研究期间,43例患者纳入分析。16例患者在ECMO治疗过程中使用了丙泊酚。治疗期间共进行了12次氧合器更换。氧合器更换发生在1.8%的ECMO日。氧合器的中位使用寿命为7天。使用丙泊酚的患者氧合器使用寿命显著更长(p = 0.02)。在接受丙泊酚治疗的患者中,需要更换氧合器的患者丙泊酚日均剂量中位数显著更低(p < 0.001)。就氧合器的生存能力而言,在ECMO中使用丙泊酚似乎是安全的。与预期相反,接受丙泊酚治疗的患者氧合器使用寿命显著更长。