Haddad S, Tamim H, Memish ZA, Arabi Y. Association of preservative-free propofol use and outcome in critically ill patients.
Am J Infect Control 2011;
39:141-7. [PMID:
20888671 DOI:
10.1016/j.ajic.2010.05.027]
[Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2010] [Revised: 05/12/2010] [Accepted: 05/12/2010] [Indexed: 10/19/2022]
Abstract
BACKGROUND
Propofol is widely used to provide sedation to patients in the intensive care unit (ICU). This study examined whether preservative-free propofol infusion independently influences outcome in critically ill patients.
METHODS
This was a nested cohort study within a randomized controlled trial. ICU patients who received preservative-free propofol and those who did not were compared. The following data were collected: demographic information, APACHE II score, admission category, chronic severe illnesses, nutritional data, and blood glucose level and insulin dose. The main exposure was the use of preservative-free propofol infusion. The main outcomes were the occurrence of ICU-acquired infections, ICU-acquired sepsis, and ICU and hospital mortality.
RESULTS
A total of 523 patients were included (no propofol group, n = 399; propofol group, n = 124). After adjustment for differences in baseline characteristics, preservative-free propofol use was associated with increased risk of ICU-acquired infections (adjusted odds ratio [aOR], 1.89, 95% confidence interval [CI], 1.17-3.06; P = .009) and ICU-acquired severe sepsis and septic shock (aOR, 1.91; 95% CI, 1.12-3.28; P = .02), but not with ICU or hospital mortality.
CONCLUSION
Preservative-free propofol infusion in critically ill patients may be associated with increased risk of ICU-acquired infections and ICU-acquired sepsis, with no significant difference in ICU or hospital mortality. This association might have been related to the use of preservative-free preparations.
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