Abstract
We examined the influence of a seven day course of nocturnal sedation with propofol on serum lipid concentrations and cellular immunities in mechanically ventilated ICU patients. Sixteen adult patients undergoing total esophagectomy were randomly allocated to receive or not to receive propofol for 7 nights. In patients who received propofol, the mean propofol dose required to maintain an adequate level of sedation, according to a Ramsay sedation score of 3 to 4, was 1.9±0.5mg•kg-1•h-1.
The concentrations of both serum triglyceride and total cholesterol increased slightly but remained normal in all patients studied. High-density-lipoprotein cholesterol (HDL-cholesterol) concentrations decreased with time in the propofol group and lowered the normal value, whereas they remained the same in patients who did not receive propofol. Statistically significant differences between the groups were found. As for cellular immunity, no significant changes were detected in any of the patients studied except for natural killer-cell activities. Since HDL-cholesterol plays a pivotal role in the elimination of triglyceride from the bloodstream, we have concluded that even if the lipid load is reduced by nocturnal administration, the infusion of propofol for more than 7 days may reduce HDL-cholesterol concentrations and lead to hypertriglyceridemia.
