Safety and efficacy of propofol with EDTA when used for sedation of surgical intensive care unit patients

D. L. Herr, K. Kelly, J. B. Hall, John A Ulatowski, G. J. Fulda, B. Cason, R. Hickey, A. M. Nejman, G. P. Zaloga, D. Teres

Research output: Contribution to journalArticle

Abstract

Objective: To compare propofol with disodium edetate (EDTA) and propofol without EDTA when used for the sedation of critically ill surgical intensive care unit (ICU) patients. Design: Prospective, randomised, multicentre trial. Patients: A total of 122 surgical ICU patients who required intubation and mechanical ventilation. Interventions: Patients were randomised to receive either propofol or propofol plus EDTA (propofol EDTA) by continuous infusion for sedation. Measurements and Results: The addition of EDTA to propofol had no effect on calcium or magnesium homeostasis, renal function, haemodynamic function, or efficacy when used for the sedation of surgical patients in the ICU. The most common adverse events were hypotension, atrial fibrillation, and hypocalcaemia. In this trial, a greater number of serious adverse events and adverse events leading to withdrawal occurred in the propofol group relative to the propofol EDTA group. There was a significantly lower crude mortality rate at 7 and 28 days for the propofol EDTA group compared with the propofol group. There were no statistically significant differences between groups with respect to depth of sedation. Conclusion: The propofol EDTA formulation had no effect on calcium or magnesium homeostasis, renal function, or sedation efficacy compared with propofol alone when used for sedation in critically ill surgical ICU patients. There was a significant decrease in mortality in the propofol EDTA group compared with the propofol group. Further investigations are needed to validate this survival benefit and elucidate a possible mechanism.

Original languageEnglish (US)
JournalIntensive Care Medicine, Supplement
Volume26
Issue number4
StatePublished - 2000

Fingerprint

Propofol
Critical Care
Intensive Care Units
Safety
Critical Illness
Magnesium
Homeostasis
Calcium
Kidney
Hypocalcemia
Mortality
Artificial Respiration
Intubation
Hypotension
Atrial Fibrillation
Multicenter Studies
Hemodynamics

Keywords

  • Calcium
  • Critical illness
  • Disodium edetate
  • Homeostasis
  • Magnesium
  • Propofol

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

Cite this

Safety and efficacy of propofol with EDTA when used for sedation of surgical intensive care unit patients. / Herr, D. L.; Kelly, K.; Hall, J. B.; Ulatowski, John A; Fulda, G. J.; Cason, B.; Hickey, R.; Nejman, A. M.; Zaloga, G. P.; Teres, D.

In: Intensive Care Medicine, Supplement, Vol. 26, No. 4, 2000.

Research output: Contribution to journalArticle

Herr, DL, Kelly, K, Hall, JB, Ulatowski, JA, Fulda, GJ, Cason, B, Hickey, R, Nejman, AM, Zaloga, GP & Teres, D 2000, 'Safety and efficacy of propofol with EDTA when used for sedation of surgical intensive care unit patients', Intensive Care Medicine, Supplement, vol. 26, no. 4.
Herr, D. L. ; Kelly, K. ; Hall, J. B. ; Ulatowski, John A ; Fulda, G. J. ; Cason, B. ; Hickey, R. ; Nejman, A. M. ; Zaloga, G. P. ; Teres, D. / Safety and efficacy of propofol with EDTA when used for sedation of surgical intensive care unit patients. In: Intensive Care Medicine, Supplement. 2000 ; Vol. 26, No. 4.
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T1 - Safety and efficacy of propofol with EDTA when used for sedation of surgical intensive care unit patients

AU - Herr, D. L.

AU - Kelly, K.

AU - Hall, J. B.

AU - Ulatowski, John A

AU - Fulda, G. J.

AU - Cason, B.

AU - Hickey, R.

AU - Nejman, A. M.

AU - Zaloga, G. P.

AU - Teres, D.

PY - 2000

Y1 - 2000

N2 - Objective: To compare propofol with disodium edetate (EDTA) and propofol without EDTA when used for the sedation of critically ill surgical intensive care unit (ICU) patients. Design: Prospective, randomised, multicentre trial. Patients: A total of 122 surgical ICU patients who required intubation and mechanical ventilation. Interventions: Patients were randomised to receive either propofol or propofol plus EDTA (propofol EDTA) by continuous infusion for sedation. Measurements and Results: The addition of EDTA to propofol had no effect on calcium or magnesium homeostasis, renal function, haemodynamic function, or efficacy when used for the sedation of surgical patients in the ICU. The most common adverse events were hypotension, atrial fibrillation, and hypocalcaemia. In this trial, a greater number of serious adverse events and adverse events leading to withdrawal occurred in the propofol group relative to the propofol EDTA group. There was a significantly lower crude mortality rate at 7 and 28 days for the propofol EDTA group compared with the propofol group. There were no statistically significant differences between groups with respect to depth of sedation. Conclusion: The propofol EDTA formulation had no effect on calcium or magnesium homeostasis, renal function, or sedation efficacy compared with propofol alone when used for sedation in critically ill surgical ICU patients. There was a significant decrease in mortality in the propofol EDTA group compared with the propofol group. Further investigations are needed to validate this survival benefit and elucidate a possible mechanism.

AB - Objective: To compare propofol with disodium edetate (EDTA) and propofol without EDTA when used for the sedation of critically ill surgical intensive care unit (ICU) patients. Design: Prospective, randomised, multicentre trial. Patients: A total of 122 surgical ICU patients who required intubation and mechanical ventilation. Interventions: Patients were randomised to receive either propofol or propofol plus EDTA (propofol EDTA) by continuous infusion for sedation. Measurements and Results: The addition of EDTA to propofol had no effect on calcium or magnesium homeostasis, renal function, haemodynamic function, or efficacy when used for the sedation of surgical patients in the ICU. The most common adverse events were hypotension, atrial fibrillation, and hypocalcaemia. In this trial, a greater number of serious adverse events and adverse events leading to withdrawal occurred in the propofol group relative to the propofol EDTA group. There was a significantly lower crude mortality rate at 7 and 28 days for the propofol EDTA group compared with the propofol group. There were no statistically significant differences between groups with respect to depth of sedation. Conclusion: The propofol EDTA formulation had no effect on calcium or magnesium homeostasis, renal function, or sedation efficacy compared with propofol alone when used for sedation in critically ill surgical ICU patients. There was a significant decrease in mortality in the propofol EDTA group compared with the propofol group. Further investigations are needed to validate this survival benefit and elucidate a possible mechanism.

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KW - Critical illness

KW - Disodium edetate

KW - Homeostasis

KW - Magnesium

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