Document Detail


Prolonged propofol use in a critically ill pregnant patient.
MedLine Citation:
PMID:  21062907     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
OBJECTIVE: To describe the prolonged use of propofol for sedation of a critically ill pregnant patient in her second trimester.
CASE SUMMARY: A 20-year-old pregnant woman at 14 weeks' gestation with non-Hodgkin's lymphoma required intubation and mechanical ventilation secondary to tumor-related airway obstruction. Immediately after intubation, propofol was initiated for sedation and maintained for 51 days with only one 5-day interruption in therapy. Over the course of the patient's stay in the intensive care unit, systemic chemotherapy was administered, resulting in a reduction in tumor burden and allowing for successful extubation. Ultimately, the fetus was deemed nonviable and the pregnancy was terminated.
DISCUSSION: Propofol is an intravenous anesthetic agent commonly used for the sedation of mechanically ventilated patients and is the only sedative agent that carries a pregnancy category B rating. Fetal outcomes following long-term use of propofol during the first trimester have not been formally evaluated and few reports of propofol use outside of early pregnancy termination, outpatient procedures, or parturition exist in the medical literature. Our patient required early termination of pregnancy; however, we were unable to determine whether fetal loss was a result of propofol use, chemotherapy administration, the use of other pharmacologic agents, or perhaps a combined effect.
CONCLUSIONS: Despite propofol's pregnancy category B rating, data are lacking in humans regarding its safe use during pregnancy and long-term developmental outcomes in children after exposure to propofol in utero. The safety of propofol as a sedative agent for critically ill pregnant patients remains unknown.
Authors:
Sharla K Tajchman; Jeffrey J Bruno
Related Documents :
16892327 - Lethal congenital contracture syndrome (lccs) and other lethal arthrogryposes in finlan...
16883447 - Misoprostol for termination of second trimester pregnancy in a scarred uterus.
2618597 - Prostaglandins and antiprogestins.
12427397 - Misoprostol in second and early third trimester for termination of pregnancies with fet...
9890227 - Interstitial ectopic pregnancy--management with laparoscopically-guided local methotrex...
1358507 - Carbonic anhydrase activity in blood of early sheep fetuses.
Publication Detail:
Type:  Journal Article     Date:  2010-11-09
Journal Detail:
Title:  The Annals of pharmacotherapy     Volume:  44     ISSN:  1542-6270     ISO Abbreviation:  Ann Pharmacother     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-12-08     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9203131     Medline TA:  Ann Pharmacother     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2018-22     Citation Subset:  IM    
Affiliation:
Division of Pharmacy, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. SKTajchman@mdanderson.org
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Prediabetes as a therapeutic target.
Next Document:  Acamprosate calcium as augmentation therapy for anxiety disorders.