Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH, USA.
Section of Pulmonary Medicine, Nationwide Children's Hospital, Columbus, OH, USA.
Lung. 2018 Aug;196(4):435-439. doi: 10.1007/s00408-018-0119-5. Epub 2018 May 24.
Flexible fiberoptic bronchoscopy (FFB) plays an important role in the surveillance of cystic fibrosis (CF) patients after lung transplantation (LTx). With rapid onset and clearance, propofol provides a safe and efficient method for sedation during FFB, yet sedation requirements for CF patients are not well described.
Due to pharmacokinetic differences for other classes of drugs in CF patients, this study was performed to examine propofol requirements for sedation during bronchoscopy in lung transplant recipients with CF.
A single-center retrospective cohort study was performed to examine propofol sedation requirements during outpatient surveillance. FFB procedures with transbronchial biopsy (TBB) in post-LTx recipients between 2009 and 2014 were conducted.
A total of 40 FFB procedures with TBB were performed 20 CF (11 females), 20 non-CF (11 females). Mean (± SD) age was 25.6 ± 9.2 (range 13-42) years and 22.2 ± 10.8 (range 11-39) years for the CF and non-CF groups, respectively. Propofol requirements were significantly higher in the CF patients compared to the non-CF patients. Mean (± SD) propofol dose for CF patients was 334 ± 86 versus 214 ± 88 mg for non-CF patients (p < 0.001). Mean (± SD) propofol dose per weight (mg/kg) was 6.5 ± 2.1 for CF patients versus 3.8 ± 1.6 for non-CF patients (p < 0.001).
Compared to a non-CF cohort, CF lung transplant recipients required higher dosages of propofol for sedation during FFB with TBB.
纤维支气管镜（FFB）在肺移植（LTx）后囊性纤维化（CF）患者的监测中起着重要作用。丙泊酚起效快、清除快，为 FFB 期间的镇静提供了一种安全有效的方法，但 CF 患者的镇静需求尚未得到很好的描述。
由于 CF 患者其他类药物的药代动力学差异，本研究旨在检查 CF 肺移植受者在纤维支气管镜检查期间使用丙泊酚镇静的要求。
进行了一项单中心回顾性队列研究，以检查 LTx 后接受门诊监测的患者进行 FFB 时的丙泊酚镇静需求。在 2009 年至 2014 年期间，对接受 TBB 的 LTx 后患者进行了 40 次 FFB 检查。
共进行了 40 次 TBB 的 FFB 检查，20 例 CF（11 例女性），20 例非 CF（11 例女性）。CF 组和非 CF 组的平均（±SD）年龄分别为 25.6±9.2（范围 13-42）岁和 22.2±10.8（范围 11-39）岁。CF 患者的丙泊酚需求量明显高于非 CF 患者。CF 患者的丙泊酚平均（±SD）剂量为 334±86 毫克，而非 CF 患者为 214±88 毫克（p<0.001）。CF 患者丙泊酚的平均（±SD）剂量/体重（mg/kg）为 6.5±2.1，而非 CF 患者为 3.8±1.6（p<0.001）。
与非 CF 队列相比，CF 肺移植受者在接受 TBB 的 FFB 期间需要更高剂量的丙泊酚镇静。
