Propofol-based sedation does not negatively influence oxygenator running time compared to midazolam in patients with extracorporeal membrane oxygenation

Int J Artif Organs. 2019 May;42(5):233-240. doi: 10.1177/0391398819833376. Epub 2019 Feb 28.

Abstract

Objective: Patients on extracorporeal membrane oxygenation are frequently in need for sedation. Use of propofol has been associated with impaired oxygenator function due to adsorption to the membrane as well as lipid load. The aim of our retrospective analysis was to compare two different sedation regimens containing either propofol or midazolam with respect to oxygenator running time.

Methods: Midazolam was used in 73 patients whereas propofol was used in 49 patients, respectively. In the propofol group, veno-arterial-extracorporeal membrane oxygenation was used predominantly (84%), while veno-venous-extracorporeal membrane oxygenation was used more often in the midazolam group (64%).

Results: Oxygenator running time until first exchange was 7 days in both groups ( p = 0.759). No statistically significant differences could be observed between the subgroup of patients receiving lipid-free (n = 24) and lipid-containing (n = 31) parenteral nutrition, respectively. Laboratory parameters like triglycerides, free hemoglobin, fibrinogen, platelets, and activated partial thromboplastin time were not significantly different between both sedation regimens ( p = 0.462, p = 0.489, p = 0.960, p = 0.134, and p = 0.843) and were not associated with oxygenator running time.

Conclusion: The use of propofol as sedative seems suitable in patients undergoing extracorporeal membrane oxygenation therapy.

Keywords: Sedation; extracorporeal membrane oxygenation; midazolam; oxygenator running time; propofol.

MeSH terms

  • Adult
  • Aged
  • Conscious Sedation / methods*
  • Equipment Failure
  • Extracorporeal Membrane Oxygenation* / adverse effects
  • Extracorporeal Membrane Oxygenation* / instrumentation
  • Extracorporeal Membrane Oxygenation* / methods
  • Female
  • Humans
  • Hypnotics and Sedatives / administration & dosage
  • Male
  • Midazolam* / administration & dosage
  • Midazolam* / adverse effects
  • Middle Aged
  • Oxygenators*
  • Propofol / administration & dosage
  • Propofol / adverse effects
  • Retrospective Studies

Substances

  • Hypnotics and Sedatives
  • Midazolam
  • Propofol