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Original Paper

Cerebral and Systemic Hemodynamic Effects of Intravenous Bolus Administration of Propofol in Neonates

Vanderhaegen J.a · Naulaers G.a · Van Huffel S.b · Vanhole C.a · Allegaert K.a

Author affiliations

aNeonatal Intensive Care Unit, University Hospitals Leuven, and bSISTA,Department of Electrical Engineering, Catholic University Leuven, Leuven, Belgium

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Neonatology 2010;98:57–63

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Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: April 21, 2009
Accepted: July 13, 2009
Published online: December 24, 2009
Issue release date: June 2010

Number of Print Pages: 7
Number of Figures: 3
Number of Tables: 1

ISSN: 1661-7800 (Print)
eISSN: 1661-7819 (Online)

For additional information: https://www.karger.com/NEO

Abstract

Objectives: To assess variability of systemic hemodynamics and its covariates following bolus propofol administration in (pre)term neonates, and to analyze the effect of propofol on cerebral tissue oxygenation index (TOI) and fractional tissue oxygen extraction measured by near-infrared spectroscopy. Methods: In (pre)term neonates, we recorded mean arterial blood pressure (MABP), saturation (SaO2), heart rate (HR) and TOI from 5 min before up to 60 min after intravenous bolus propofol (3 mg kg–1) administration during elective chest tube removal. Covariate analysis included postmenstrual age (PMA ≤ or >37 weeks), postnatal age (PNA ≤ or >10 days), comedication (fentanyl +/– midazolam) and congenital cardiopathy (yes/no). Fractional tissue oxygen extraction was calculated as (SaO2 – TOI)/SaO2. Results: Twenty recordings in 19 neonates were assessed. Following propofol administration, an abrupt, minor decrease in HR and SaO2 was seen with fast recovery, while MABP decreased up to 1 h. TOI decreased during the first 3 min, reflecting an imbalance between cerebral oxygen delivery and demand. Despite sustained decrease in MABP, TOI then returned to baseline, suggesting a better balance between oxygen delivery and demand. PNA ≤10 days, comedication and absence of cardiopathy were associated with more subtle decreases in cerebral oxygenation and faster recovery. Conclusions: Propofol-induced decrease in HR, SaO2 and cerebral oxygenation is short lasting while a decrease in MABP is observed up to 60 min. The variability in the effects of propofol is influenced by PNA, comedication or cardiopathy. Near-infrared spectroscopy can be used to assess hemodynamic effects of hypnotics on the cerebral oxygenation.

© 2009 S. Karger AG, Basel


References

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Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: April 21, 2009
Accepted: July 13, 2009
Published online: December 24, 2009
Issue release date: June 2010

Number of Print Pages: 7
Number of Figures: 3
Number of Tables: 1

ISSN: 1661-7800 (Print)
eISSN: 1661-7819 (Online)

For additional information: https://www.karger.com/NEO


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