PURPOSE: For over decades Propofol use has been reported to cause unexplained metabolic acidosis and lactic acidemia with a high mortality rate, especially in children. Although well established in pediatric literature, the existence of Propofol induced metabolic acidosis in adults remains controversial. The goal of this study is to explore the association between propofol use and metabolic acidosis in adults.
METHODS: The study design was a retrospective review of case series. 124 charts from Avera McKennan hospital, South Dakota, dated from 09/09 to 12/09 were reviewed. Data on population characteristics including age, gender, race, presence of co morbid conditions, presence of predisposing factors for metabolic acidosis such as prolonged hypoxia, hypotension, sepsis, etc, as well as preexisting acidosis was collected. Paired T test analysis was performed for blood Ph, bicarbonate levels, and anion gap before and after Propofol infusion. The influence of Propofol dose, duration, average rate of infusion and type of infusion (intermittent versus continuous) on blood Ph and bicarbonate levels were also analyzed.
RESULTS: The average anion gap before and after Propofol was 10.01 mEq/L and 8.35 mEq/L respectively, average pH before and after Propofol was 7.36 and 7.42 respectively, and average serum bicarbonate before and after Propofol was 23.53 mEq/L and 25.13 mEq/L respectively. Also blood pH, bicarbonate and anion gap before and after Propofol infusion were not statistically significant irrespective of the duration of Propofol use, the total dose of Propofol, the average rate of Propofol infusion, and the type of infusion.
CONCLUSION: No association between Propofol use and metabolic acidosis was found in these 124 patients. However this could be due to a small sample size, a larger population at McKennan will be analyzed by the researchers.
CLINICAL IMPLICATIONS: The results of the study did not show an association between Propofol use and metabolic acidosis. Hence in patients who develop metabolic acidosis and who are on Propofol, other causes for the acidosis could be considered.
DISCLOSURE: Edward Zawada, Jr., No Financial Disclosure Information; No Product/Research Disclosure Information