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. 1992 Sep 12;305(6854):613–616. doi: 10.1136/bmj.305.6854.613

Metabolic acidosis and fatal myocardial failure after propofol infusion in children: five case reports.

T J Parke 1, J E Stevens 1, A S Rice 1, C L Greenaway 1, R J Bray 1, P J Smith 1, C S Waldmann 1, C Verghese 1
PMCID: PMC1883365  PMID: 1393073

Abstract

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 in these children could not be defined, propofol may have been a contributing factor.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

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