BJA Advance Access published online on January 21, 2005
British Journal of Anaesthesia, doi:10.1093/bja/aei074
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
1 Institute of Anaesthesia and Intensive Care, Catholic University of the Sacred Heart, Largo Francesco Vito 1, 00168 Rome, Italy
* To whom correspondence should be addressed. Background. About 98% of plasma propofol is bound to albumin. We investigated if severe hypoalbuminaemia may affect the accuracy of a target-controlled infusion (TCI) device, the Diprifusor, during sedation in critically ill patients. Methods. Ten critically ill hypoalbuminaemic patients (<24 g litre-1) and 10 critically ill normoalbuminaemic patients (>32 g litre-1) were included in this study. They underwent sedation with propofol, aimed at a Ramsey sedation score of 4-5. The Diprifusor was used to achieve target propofol plasma concentrations that ranged between 0.6 and 1.5 mg litre-1. Propofol concentration was measured by high-performance liquid chromatography 5 min, 15 min, 30 min, 1 h, 2 h, 4 h, 6 h and 8 h after starting TCI. The accuracy of TCI was evaluated by calculating performance errors [PE=100x(measured concentration-predicted concentration)/predicted concentration], absolute and relative individual median performance errors (MDAPE and MDPE) and divergence (the slope of individual regression lines between PEs and time). Results. PEs [median (range)] were -7 (-65, 79) in hypoalbuminaemic patients and -2 (-53, 188) in normoalbuminaemic patients; absolute PEs were 21 (1, 79) and 22 (0, 188). No significant difference was observed between the two groups. MDPE, MDAPE and divergence values were also similar. In most patients the accuracy of TCI increased with time because higher PE values were observed during the first 30 min. Conclusions. Hypoalbuminaemia does not affect the accuracy of Diprifusor during sedation with propofol in critically ill patients.
Accepted November 26, 2004
Clinical Investigation
Hypoalbuminaemia does not impair Diprifusor performance during sedation with propofol
2 Institute of Hygiene, Catholic University of the Sacred Heart, Largo Francesco Vito 1, 00168 Rome, Italy
F. Cavaliere, E-mail: f.cavaliere{at}rm.unicatt.it
Abstract 
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  N. Mongardon, F. Servin, M. Perrin, E. Bedairia, S. Retout, C. Yazbeck, P. Faucher, P. Montravers, J.-M. Desmonts, and J. Guglielminotti Predicted Propofol Effect-Site Concentration for Induction and Emergence of Anesthesia During Early Pregnancy Anesth. Analg., July 1, 2009; 109(1): 90 - 95. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. B. Glen and F. Servin Evaluation of the predictive performance of four pharmacokinetic models for propofol Br. J. Anaesth., May 1, 2009; 102(5): 626 - 632. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. R. Munoz, L. I. Cortinez, M. E. Ibacache, and F. R. Altermatt Remifentanil Requirements During Propofol Administration to Block the Somatic Response to Skin Incision in Children and Adults Anesth. Analg., January 1, 2007; 104(1): 77 - 80. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. Takizawa, E. Sato, N. Ito, Y. Ogino, H. Hiraoka, F. Goto, F. Cavaliere, G. Conti, U. Moscato, F. Meo, et al. Hypoalbuminaemia and propofol pharmacokinetics Br. J. Anaesth., October 1, 2005; 95(4): 559 - 559. [Full Text] [PDF]
|
|