{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T17:29:18Z","timestamp":1782926958895,"version":"3.54.5"},"reference-count":27,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T00:00:00Z","timestamp":1768176000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Adequate sedation is crucial in the care of critically ill children. Propofol, known for its rapid onset, reliable patient response, and short duration of action, offers an attractive pharmacologic profile. However, concerns for propofol-related infusion syndrome (PRIS) have limited its use in pediatric critical care. This study examined the relationship between propofol administration and PRIS characteristics in a single medical-surgical pediatric intensive care unit (PICU). We hypothesized that continuous propofol infusion, even when judiciously exceeding current recommended doses and durations, is not associated with cardiovascular collapse, metabolic acidosis, or other PRIS-related characteristics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This is a retrospective single-center study in the non-cardiac medical\/surgical PICU at a tertiary academic medical center of 554 patients. Children aged 0\u201317 years admitted to the PICU from 1\/1\/2000 to 9\/30\/2024, who received propofol infusions for \u226512\u2005h and\/or \u22652.4\u2005mg\/kg\/hour (40 mcg\/kg\/min) were included. The primary outcome was in-hospital mortality; secondary outcomes included intensive care unit (ICU) length of stay, bradycardia during infusion, and metabolic acidosis during infusion. Data was compared across age groups (&amp;lt;6 months, 6\u201312 months, 1\u20135 years, 6\u201317 years) and medical\/surgical diagnosis using the chi-square test for homogeneity and the Kruskal\u2013Wallis tests.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 554 patients, the median age was 5.5 (IQR 1.5\u201312.1) years. The median propofol infusion rate was 3.0 (IQR 1.7\u20134.2) mg\/kg\/hour [50 (IQR 28\u201370) mcg\/kg\/min], median duration was 22.8 (IQR 16.4\u201342.4) hours, and median ICU length of stay was 4.7 (IQR 2.0\u201310.4) days. One case of PRIS was observed (0.2%). There were 26 (4.7%) in-hospital deaths, nonattributable to PRIS. Bradycardia occurred in 146 (26.4%) patients, and 19 (3.4%) patients developed metabolic acidosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>In this single-center retrospective study, one case of PRIS was identified. While rare, its occurrence underscores the need for vigilance. Propofol remains a viable sedation option when used with appropriate monitoring in pediatric critical care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fped.2025.1718328","type":"journal-article","created":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T07:57:32Z","timestamp":1768204652000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["The safety of high dose continuous propofol infusion in the pediatric intensive care unit at an academic medical center"],"prefix":"10.3389","volume":"13","author":[{"given":"Oluwatomini A.","family":"Fashina","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grace M.","family":"Arteaga","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheri S.","family":"Crow","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rahul","family":"Kashyap","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryan D.","family":"Frank","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xai","family":"Khang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole M.","family":"Andrijasevic","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danette L.","family":"Bruns","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashley V.","family":"Wong Grossman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,1,12]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"491","DOI":"10.1046\/j.1460-9592.1998.00282.x","article-title":"Propofol infusion syndrome in children","volume":"8","author":"Bray","year":"1998","journal-title":"Paediatr Anaesth"},{"key":"B2","doi-asserted-by":"publisher","first-page":"S225","DOI":"10.1097\/PCC.0000000000000756","article-title":"Sedation and analgesia in pediatric cardiac critical care","volume":"17","author":"Nasr","year":"2016","journal-title":"Pediatr Crit Care Med"},{"key":"B3","doi-asserted-by":"publisher","first-page":"448","DOI":"10.1016\/j.bja.2018.12.025","article-title":"Propofol infusion syndrome: a structured literature review and analysis of published case reports","volume":"122","author":"Hemphill","year":"2019","journal-title":"Br J Anaesth"},{"key":"B4","year":""},{"key":"B5","doi-asserted-by":"publisher","first-page":"786","DOI":"10.1177\/0310057X0203000612","article-title":"Use of propofol infusion in Australian and New Zealand paediatric intensive care units","volume":"30","author":"Festa","year":"2002","journal-title":"Anaesth Intensive Care"},{"key":"B6","doi-asserted-by":"publisher","first-page":"e150","DOI":"10.1097\/PCC.0b013e3182388a95","article-title":"Use of propofol in pediatric intensive care units: a national survey in Germany","volume":"13","author":"Kruessell","year":"2012","journal-title":"Pediatr Crit Care Med"},{"key":"B7","doi-asserted-by":"publisher","first-page":"e117","DOI":"10.1097\/PCC.0000000000000608","article-title":"Propofol use in Israeli PICUs","volume":"17","author":"Rosenfeld-Yehoshua","year":"2016","journal-title":"Pediatr Crit Care Med"},{"key":"B8","doi-asserted-by":"publisher","first-page":"e66","DOI":"10.1097\/PCC.0000000000000021","article-title":"Is propofol a friend or a foe of the pediatric intensivist? 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