Intensive Care Medicine

, Volume 36, Issue 10, pp 1675–1680

Target-controlled infusion of propofol for sedation in patients with non-invasive ventilation failure due to low tolerance: a preliminary study

  • Benjamin Clouzeau
  • Hoang-Nam Bui
  • Frederic Vargas
  • Marieke Grenouillet-Delacre
  • Emmanuelle Guilhon
  • Didier Gruson
  • Gilles Hilbert
Original

DOI: 10.1007/s00134-010-1904-7

Cite this article as:
Clouzeau, B., Bui, HN., Vargas, F. et al. Intensive Care Med (2010) 36: 1675. doi:10.1007/s00134-010-1904-7

Abstract

Purpose

Non-invasive ventilation (NIV) in critically ill patients is associated with a high failure rate. This prospective study assessed the feasibility and safety of target-controlled infusion (TCI) of propofol for conscious sedation during NIV in patients with NIV failure due to low tolerance.

Methods

Ten patients with NIV failure due to discomfort, agitation and/or refusal to continue with this ventilatory support were included; seven had acute respiratory failure and three had acute hypercapnic respiratory failure. Patients were sedated by TCI of propofol during NIV sessions. Blood gas analysis, cardiorespiratory and ventilatory parameters, propofol concentration (Cpt) required, comfort and adverse events were recorded.

Results

Patients received a total of 85 NIV sessions, totalling 180 h of NIV under TCI of propofol (mean Cpt, 0.82 ± 0.25 μg/ml). NIV under TCI of propofol significantly improved arterial blood gas analyses: mean Pa/FiO2 ratio increased from 167 ± 68 pre-session to 195 ± 68 post-session (p < 0.05), mean PaCO2 decreased from 57.8 ± 15.3 to 49 ± 9.8 mmHg (p < 0.05) and mean pH increased from 7.36 ± 0.04 to 7.4 ± 0.03 (p < 0.05). Three patients required endotracheal intubation, two due to evolution of underlying disease and one because of a seizure disorder. Eight patients were discharged from the intensive care unit and two died.

Conclusions

This preliminary study shows that in a selected population, TCI of propofol can facilitate acceptance of NIV. Within the limits of a pilot study, TCI of propofol seems to be safe and effective for the treatment of NIV failure due to low tolerance.

Keywords

Non-invasive ventilation Target-controlled infusion Propofol Sedation Acute respiratory failure 

Supplementary material

134_2010_1904_MOESM1_ESM.doc (284 kb)
(DOC 283 kb)

Copyright information

© Copyright jointly held by Springer and ESICM 2010

Authors and Affiliations

  • Benjamin Clouzeau
    • 1
  • Hoang-Nam Bui
    • 1
  • Frederic Vargas
    • 1
  • Marieke Grenouillet-Delacre
    • 1
  • Emmanuelle Guilhon
    • 1
  • Didier Gruson
    • 1
  • Gilles Hilbert
    • 1
  1. 1.Medical Intensive Care UnitPellegrin Teaching HospitalBordeaux CedexFrance