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Propofol Formulation Affects Myocardial Function in Newborn Infants

  • Anna Claudia MassoloEmail author
  • Stefania Sgrò
  • Fiammetta Piersigilli
  • Karel Allegaert
  • Irma Capolupo
  • Jole Rechichi
  • Francesca Landolfo
  • Flaminia Calzolari
  • Alessandra Toscano
  • Sergio Picardo
  • Neil Patel
Original Article

Abstract

This study aimed to evaluate the effects of propofol in diluted and undiluted formulations on cardiac function in infants. Infants > 30 days received propofol sedation for central line insertion. Cases were divided into two groups: those who received undiluted 1% propofol (P1%); and those who received a diluted formulation (Pd) of equal volumes propofol 1% and 0.9% NaCl. Echocardiograms were performed pre (t0)-, immediately post (t1)-, and 1-h post (t2) propofol administration. Myocardial deformation was assessed with tissue Doppler imaging (TDI) analysis and peak longitudinal strain (LS). 18 cases were included: nine (50%) P1% and nine (50%) Pd. In the P1% group, TDI velocities and LS were significantly reduced at t1 and t2. In the Pd Group, only TDI velocities in the left ventricle were reduced at t1, but not at t2. Dilution of propofol may minimize myocardial dysfunction while maintaining adequate sedation in infants. Further comparative studies are needed to investigate the safety and efficacy of this approach.

Keywords

Myocardial strain Tissue doppler Cardiac function Propofol Formulation Hemodynamics 

Abbreviations

BP

Blood pressure

CL

Central line

DBP

Diastolic blood pressure

TDI E’

Diastolic velocity

ECMO

Extra corporeal membrane oxygenation

FLACC

Face, legs, activity, cry, and consolability scale

HR

Heart rate

LV

Left ventricle

LS

Longitudinal strain

P1%

Propofol 1%

Pd

Propofol diluted

PP

Pulse pressure

RV

Right ventricle

SR

Sarcoplasmatic reticulum

STE

Speckle tracking echocardiography

SBP

Systolic blood pressure

TDI S’

Systolic velocity

TDI

Tissue doppler imaging

SpO2

Transcutaneous oxygen saturation

Notes

Acknowledgements

We are grateful to the neonatal clinical staff at the Department of Medical and Surgical Neonatology for their assistance with the study, and to Dr Pietro Bagolan and Dr Esther Aspinall for their expert advice in design and data analysis.

Compliance With Ethical Standards

Conflict of interest

All authors declare that there are no known financial or conflicts of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The study was approved by our Institutional Review Board and as a retrospective analysis with no patient identifiable information, and therefore was approved without need for written consent.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Anna Claudia Massolo
    • 1
    Email author
  • Stefania Sgrò
    • 2
  • Fiammetta Piersigilli
    • 1
  • Karel Allegaert
    • 3
    • 4
  • Irma Capolupo
    • 1
  • Jole Rechichi
    • 1
  • Francesca Landolfo
    • 1
  • Flaminia Calzolari
    • 1
  • Alessandra Toscano
    • 1
  • Sergio Picardo
    • 2
  • Neil Patel
    • 5
  1. 1.Department of Medical and Surgical NeonatologyBambino Gesù Children’s Hospital, IRCCSRomeItaly
  2. 2.Department of AnesthesiologyBambino Gesù Children’s Hospital, IRCCSRomeItaly
  3. 3.Department of Development and RegenerationKU LeuvenLeuvenBelgium
  4. 4.Division of Neonatology, Department of PediatricsErasmus MC Sophia Children’s Hospital, University Medical Center RotterdamRotterdamThe Netherlands
  5. 5.Department of NeonatologyRoyal Hospital for ChildrenGlasgowUK

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