Authors
TJ Parke, JE Stevens, AS Rice, CL Greenaway, RJ Bray, PJ Smith, CS Waldmann, C Verghese
Publication date
1992/9/12
Journal
British Medical Journal
Volume
305
Issue
6854
Pages
613-616
Publisher
British Medical Journal Publishing Group
Description
OBJECTIVE
To examine the possible contribution of sedation with propofol in the deaths of children who were intubated and required intensive care.
DESIGN
Case note review.
SETTING
Three intensive care units.
SUBJECTS
Five children with upper respiratory tract infections aged between 4 weeks and 6 years.
RESULTS
Four patients had laryngotracheo-bronchitis and one had bronchiolitis. All were sedated with propofol. The clinical course in all five cases was remarkably similar: an increasing metabolic acidosis was associated with brady-arrhythmia and progressive myocardial failure, which did not respond to resuscitative measures. All children developed lipaemic serum after starting propofol. These features are not usually associated with respiratory tract infections. No evidence was found of viral myocarditis, which was considered as a possible cause of death.
CONCLUSION
Although the exact cause of death …
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