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    Lucas, Sarah Scarpace Nasr, Viviane G. Ng, Angelica J. Joe, Charlene Bond, Meredyth and DiNardo, James A. 2016. Pediatric Cardiac Intensive Care Society 2014 Consensus Statement. Pediatric Critical Care Medicine, Vol. 17, p. S3.

    Nasr, Viviane G. and DiNardo, James A. 2016. Sedation and Analgesia in Pediatric Cardiac Critical Care. Pediatric Critical Care Medicine, Vol. 17, p. S225.

    Kajimoto, Masaki Atkinson, Douglas B Ledee, Dolena R Kayser, Ernst-Bernhard Morgan, Phil G Sedensky, Margaret M Isern, Nancy G Des Rosiers, Christine and Portman, Michael A 2014. Propofol compared with isoflurane inhibits mitochondrial metabolism in immature swine cerebral cortex. Journal of Cerebral Blood Flow & Metabolism, Vol. 34, Issue. 3, p. 514.

    Koriyama, Hiromi Duff, Jonathan P. Guerra, Gonzalo Garcia and Chan, Alice W. 2014. Is Propofol a Friend or a Foe of the Pediatric Intensivist? Description of Propofol Use in a PICU*. Pediatric Critical Care Medicine, Vol. 15, Issue. 2, p. e66.

    Agudelo, S.C. Mencía, S. Faro, A. Escudero, V. Sanavia, E. and López-Herce, J. 2012. Continuous propofol perfusion in critically ill children. Medicina Intensiva (English Edition), Vol. 36, Issue. 6, p. 410.

    Agudelo, S.C. Mencía, S. Faro, A. Escudero, V. Sanavia, E. and López-Herce, J. 2012. Propofol en perfusión continua en niños en estado crítico. Medicina Intensiva, Vol. 36, Issue. 6, p. 410.


Propofol as a bridge to extubation for high-risk children with congenital cardiac disease

  • Sarena N. Teng (a1), Jon Kaufman (a1) (a2), Angela S. Czaja (a1), Robert H. Friesen (a3) and Eduardo M. da Cruz (a2)
  • DOI:
  • Published online: 19 October 2010

Children with congenital cardiac defects may have associated chromosomal anomalies, airway compromise, and/or pulmonary hypertension, which can pose challenges to adequate sedation, weaning from mechanical ventilation, and successful extubation. Propofol, with its unique properties, may be used as a bridge to extubation in certain cardiac populations.

Materials and methods

We retrospectively reviewed 0–17-year-old patients admitted to the Cardiac Intensive Care Unit between January, 2007 and September, 2008, who required mechanical ventilation and received a continuous infusion of propofol as a bridge to extubation. Medical charts were reviewed for demographics, associated comorbidities, as well as additional sedation medications and haemodynamic trends including vital signs and vasopressor support during the peri-infusion period. Successful extubation was defined as no re-intubation required for respiratory failure within 48 hours. Outcomes measured were successful extubation, evidence for propofol infusion syndrome, haemodynamic stability, and fluid and inotropic requirements.


We included 11 patients for a total of 12 episodes. Propofol dose ranged from 0.4 to 5.6 milligram per kilogram per hour with an average infusion duration of 7 hours. All patients were successfully extubated, and none demonstrated worsening metabolic acidosis suggestive of the propofol infusion syndrome. All patients remained haemodynamically stable during the infusion with average heart rates and blood pressures remaining within age-appropriate ranges. One patient received additional fluid but no increase in vasopressors was needed.


This study suggests that propofol infusions may allow for successful extubation in a certain population of children with congenital cardiac disease. Further studies are required to confirm whether propofol is an efficient and safe alternative in this setting.

Corresponding author
Correspondence to: Dr E. M. da Cruz, MD, Head, Pediatric Cardiac Critical Care Program, Director, Cardiac Intensive Care Unit & Cardiac Progressive Care Unit, Professor of Pediatrics, The Children’s Hospital, University of Colorado at Denver, School of Medicine, 13121 East 16th Avenue, B-100, Aurora, CO 80045, United States of America. Tel: +1 720 777 6992; Fax: +1 720 777 7290; E-mail:
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7.DE Withington , MK Decell , TA Ayed . A case of propofol toxicity: further evidence for a causal mechanism. Pediatr Anaesth 2004; 14: 505508.

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11.J Sato , S Saito , H Jonokoshi , Correlation and linear regression between blood pressure decreases after a test dose injection of propofol and that following anaesthesia induction. Anaesth Intensive Care 2003; 31: 523528.

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Cardiology in the Young
  • ISSN: 1047-9511
  • EISSN: 1467-1107
  • URL: /core/journals/cardiology-in-the-young
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