PMID- 35350154
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220401
IS  - 1551-6776 (Print)
IS  - 2331-348X (Electronic)
IS  - 1551-6776 (Linking)
VI  - 27
IP  - 3
DP  - 2022
TI  - Adherence to a Pediatric Continuous Infusion Propofol Policy for Sedation in 
      Mechanically Ventilated Patients: Opportunities for Change and Improvement.
PG  - 263-269
LID - 10.5863/1551-6776-27.3.263 [doi]
AB  - OBJECTIVE: To evaluate adherence to an institutional continuous infusion propofol 
      policy for sedation in mechanically ventilated patients, investigate the rate of 
      propofol-related infusion syndrome (PRIS), and explore areas of improvement to 
      enhance policy compliance and safety. METHODS: This was a single center, 
      retrospective chart review of patients admitted to a pediatric or cardiac 
      intensive care unit within a large free-standing quaternary care pediatric 
      hospital who received continuous propofol for non-procedural continuous sedation 
      for at least 6 hours between 2014 and 2019. Propofol exposure (dose and 
      duration), laboratory data, and hemodynamic outcomes of patients were evaluated. 
      RESULTS: A total of 104 patients (108 admissions and 133 treatment courses) met 
      inclusion criteria. Policy adherence to propofol dosing and duration limitations 
      were 70% (93/133 courses) and 68% (91/133 courses), respectively. Adherence to 
      all elements of laboratory and hemodynamic monitoring was 23%. Hypotension and 
      bradycardia were common among patients during propofol treatment courses. Except 
      for hypertriglyceridemia, no significant difference in specific laboratory values 
      were detected between patients exposed to greater than 66 mcg/kg/min (4 
      mg/kg/hr), compared with those exposed to less than 66 mcg/kg/min of propofol. 
      Patients receiving therapy for longer than 48 hours had the highest rates of 
      laboratory values associated with PRIS. No patient in the study cohort met full 
      criteria for PRIS. CONCLUSIONS: Adherence to elements of an institutional 
      propofol policy was variable. Improvements in policy adherence may be enhanced by 
      updating policy features, leveraging the electronic medical record order-set, and 
      gaining consensus among key stakeholders.
CI  - Copyright. Pediatric Pharmacy Association. All rights reserved. For permissions, 
      email: mhelms@pediatricpharmacy.org 2022.
FAU - Martin, Ashley M
AU  - Martin AM
AD  - Department of Pharmacy (AMM, AT, PDR), Children's Hospital Colorado, Anschutz 
      Medical Campus, Aurora, CO.
FAU - Tribuzi, Andrea
AU  - Tribuzi A
AD  - Department of Pharmacy (AMM, AT, PDR), Children's Hospital Colorado, Anschutz 
      Medical Campus, Aurora, CO.
FAU - Schieber, Maggie L
AU  - Schieber ML
AD  - Department of Pharmacy (AMM, AT, PDR), Children's Hospital Colorado, Anschutz 
      Medical Campus, Aurora, CO.
FAU - Reiter, Pamela D
AU  - Reiter PD
AD  - Department of Pharmacy (AMM, AT, PDR), Children's Hospital Colorado, Anschutz 
      Medical Campus, Aurora, CO.
AD  - Skaggs School of Pharmacy and Pharmaceutical Sciences (MLS, PDR), University of 
      Colorado, Anschutz Medical Campus, Aurora, CO.
LA  - eng
PT  - Journal Article
DEP - 20220321
PL  - United States
TA  - J Pediatr Pharmacol Ther
JT  - The journal of pediatric pharmacology and therapeutics : JPPT : the official 
      journal of PPAG
JID - 101089851
PMC - PMC8939281
OTO - NOTNLM
OT  - PRIS
OT  - adherence
OT  - order-set
OT  - propofol
OT  - safety
OT  - sedation
COIS- Disclosures. The authors declare no conflicts or financial interest in any 
      product or service mentioned in the manuscript, including grants, equipment, 
      medications, employment, gifts, and honoraria. The authors had full access to all 
      the data in the study and take responsibility for the integrity of the data and 
      the accuracy of the data analysis.
EDAT- 2022/03/31 06:00
MHDA- 2022/03/31 06:01
PMCR- 2022/01/01
CRDT- 2022/03/30 05:06
PHST- 2021/05/04 00:00 [received]
PHST- 2021/07/23 00:00 [accepted]
PHST- 2022/03/30 05:06 [entrez]
PHST- 2022/03/31 06:00 [pubmed]
PHST- 2022/03/31 06:01 [medline]
PHST- 2022/01/01 00:00 [pmc-release]
AID - 10.5863/1551-6776-27.3.263 [doi]
PST - ppublish
SO  - J Pediatr Pharmacol Ther. 2022;27(3):263-269. doi: 10.5863/1551-6776-27.3.263. 
      Epub 2022 Mar 21.