Department of Pulmonology, Allergology and Pulmonary Oncology, Poznań University of Medical Sciences, University Hospital of Lord's Transfiguration, Poznań, Poland.
Eur Rev Med Pharmacol Sci. 2020 Nov;24(22):11900-11908. doi: 10.26355/eurrev_202011_23848.
Flexible video bronchoscopy (FVB) performed under sedation is a useful procedure in adults with cystic fibrosis (CF). Propofol dosage for CF is poorly described, although it is of high importance for professionals. The study aimed to assess whether propofol dosage should be higher in adults CF undergoing sedation during FVB.
50 adult CF and non-CF patients undergoing sedation during FVB were included. Clinical features of studied patients were assessed. In CF group spirometry, liver enzymes, inflammatory biomarkers, albumin, protein concentration, WBC were estimated. Propofol and fentanyl dosage was calculated. Multiple regression model was performed.
CF patients were characterized by a lower mean value of body weight and lower mean requirement of total propofol (135 mg in CF vs. 145 mg in non-CF). Calculated propofol dose per kg of body weight was significantly higher in CF (2.43 mg/kg vs. 2.04 mg/kg) and did not depend on the bronchopulmonary disease stage. Propofol dose per kg of body weight was predicted by CF status (CF vs. non-CF), sex, and age.
Adult CF patients not receiving immunosuppressive therapy require higher propofol dose per kg of body weight compared to non-CF, independently on bronchopulmonary disease stage showing a narrow therapeutic window for propofol in CF group.
在镇静下进行的柔性支气管镜检查（FVB）是成人囊性纤维化（CF）患者的一种有用的程序。尽管对于专业人员来说非常重要，但 CF 患者使用的异丙酚剂量描述较差。该研究旨在评估在 CF 患者接受 FVB 镇静期间，异丙酚剂量是否应该更高。
纳入 50 名接受镇静下 FVB 的成年 CF 和非 CF 患者。评估了研究患者的临床特征。在 CF 组中，评估了肺功能、肝酶、炎症生物标志物、白蛋白、蛋白质浓度、白细胞计数。计算了异丙酚和芬太尼的剂量。进行了多元回归模型。
CF 患者的平均体重值较低，总异丙酚的平均需求量较低（CF 组 135mg，非 CF 组 145mg）。CF 患者的每公斤体重异丙酚剂量计算值明显更高（2.43mg/kg 比 2.04mg/kg），且与支气管肺部疾病阶段无关。每公斤体重的异丙酚剂量由 CF 状态（CF 与非 CF）、性别和年龄预测。
与非 CF 患者相比，未接受免疫抑制治疗的成年 CF 患者需要更高的每公斤体重异丙酚剂量，与支气管肺部疾病阶段无关，这表明 CF 组的异丙酚治疗窗较窄。
