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Sedation with Propofol for Bronchoscopy in Cystic Fibrosis Lung Transplant Recipients

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Abstract

Introduction

Flexible fiberoptic bronchoscopy (FFB) plays an important role in the surveillance of cystic fibrosis (CF) patients after lung transplantation (LTx). With rapid onset and clearance, propofol provides a safe and efficient method for sedation during FFB, yet sedation requirements for CF patients are not well described.

Objectives

Due to pharmacokinetic differences for other classes of drugs in CF patients, this study was performed to examine propofol requirements for sedation during bronchoscopy in lung transplant recipients with CF.

Methods

A single-center retrospective cohort study was performed to examine propofol sedation requirements during outpatient surveillance. FFB procedures with transbronchial biopsy (TBB) in post-LTx recipients between 2009 and 2014 were conducted.

Results

A total of 40 FFB procedures with TBB were performed 20 CF (11 females), 20 non-CF (11 females). Mean (± SD) age was 25.6 ± 9.2 (range 13–42) years and 22.2 ± 10.8 (range 11–39) years for the CF and non-CF groups, respectively. Propofol requirements were significantly higher in the CF patients compared to the non-CF patients. Mean (± SD) propofol dose for CF patients was 334 ± 86 versus 214 ± 88 mg for non-CF patients (p < 0.001). Mean (± SD) propofol dose per weight (mg/kg) was 6.5 ± 2.1 for CF patients versus 3.8 ± 1.6 for non-CF patients (p < 0.001).

Conclusions

Compared to a non-CF cohort, CF lung transplant recipients required higher dosages of propofol for sedation during FFB with TBB.

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Author information

Author notes

  1. Carrie Ho

    Present address: Hospital of the University of Pennsylvania, Philadelphia, PA, USA

Authors and Affiliations

  1. Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH, USA

    Carrie Ho, Don Hayes Jr., Mark L. Splaingard, Dmitry Tumin & Eric A. Lloyd

  2. Department of Internal Medicine, The Ohio State University College of Medicine, Columbus, OH, USA

    Don Hayes Jr.

  3. Section of Pulmonary Medicine, Nationwide Children’s Hospital, Columbus, OH, USA

    Carrie Ho, Don Hayes Jr. & Mark L. Splaingard

  4. Department of Anesthesiology & Pain Medicine, Nationwide Children’s Hospital, Columbus, OH, USA

    Dmitry Tumin

  5. Section of Critical Care Medicine, Nationwide Children’s Hospital, 700 Children’s Drive, Columbus, OH, 43205, USA

    Eric A. Lloyd

  6. Department of Internal Medicine, University of Kentucky College of Medicine, Lexington, KY, USA

    Medhi Khosravi

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  2. Don Hayes Jr.
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Contributions

CH: conception and design, acquisition of data, interpretation of data, and drafted manuscript. DH Jr: conception and design, acquisition of data, interpretation of data, and manuscript revision. MK: conception and design, and interpretation of data. DT: statistical analysis, interpretation of data, and manuscript revision. MLS: conception and design, interpretation of data, and manuscript revision. EAL: conception and design, interpretation of data, and manuscript revision.

Corresponding author

Correspondence to Eric A. Lloyd.

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Ho, C., Hayes, D., Khosravi, M. et al. Sedation with Propofol for Bronchoscopy in Cystic Fibrosis Lung Transplant Recipients. Lung 196, 435–439 (2018). https://doi.org/10.1007/s00408-018-0119-5

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  • DOI: https://doi.org/10.1007/s00408-018-0119-5

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