Survey of propofol infusions in PICUs in North America

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The objective of this survey was to assess the current use of continuous infusion propofol in PICUs across the United States and Canada” Kurek et al (2019).

Abstract:

OBJECTIVE: The objective of this survey was to assess the current use of continuous infusion propofol in PICUs across the United States and Canada.

METHODS: A list of institutions with PICU beds/units was identified through the residency directories available on the American Society of Health-Systems Pharmacists (ASHP) and Canadian Society of Hospital Pharmacists (CHSP) Web sites. A REDCap questionnaire was sent to each identified institution’s program director via email. An initial reminder email was sent out 2 weeks later and a second reminder email was sent 4 weeks after the initial request. The survey was closed at 6 weeks.

RESULTS: A total of 514 emails were sent to residency program directors, and 50 pharmacists responded to the survey. Of the pharmacists that did respond, 27 (54%) reported using propofol while 23 (46%) did not. Of those that did not, 43.5% reported the FDA boxed warning as the primary reason. Thirty-seven percent of respondents using propofol felt comfortable using a maximum infusion rate of 200 mcg/kg/min. Twenty-nine percent, 25%, and 33% of those who responded as using propofol felt comfortable using this agent for a maximum duration of 24, 48, and 72 hours, respectively. The majority of respondents using propofol did not have a case of propofol-related infusion syndrome.

CONCLUSIONS: Despite the FDA warning, propofol is used as a continuous infusion (with variable limitations) by a majority of pharmacists in North America. Self-reported incidence of propofol-related infusion syndrome (PRIS) remains low.

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Reference:

Kurek, K.J., Harthan, A.A. and Tripathi, S. (2019) Survey of Pharmacists Regarding the Use of Propofol Infusions in the PICUs in North America. The Journal of Pediatric Pharmacology and Therapeutics. 24(6), p.473-478. doi: 10.5863/1551-6776-24.6.473.

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