Propofol Formulation Affects Myocardial Function in Newborn Infants
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.
KeywordsMyocardial strain Tissue doppler Cardiac function Propofol Formulation Hemodynamics
Diastolic blood pressure
- TDI E’
Extra corporeal membrane oxygenation
Face, legs, activity, cry, and consolability scale
Speckle tracking echocardiography
Systolic blood pressure
- TDI S’
Tissue doppler imaging
Transcutaneous oxygen saturation
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.
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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