Do Intensive Care Drug Infusions Support Microbial Growth?

Graystone, S; Wells, Maurean; Farrell, David J.

doi:10.1177/0310057x9702500608

Cited by 33 publications

(16 citation statements)

References 16 publications

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“…[12][13][14][15][16] PE has been associated with pain-oninjection, 17,18 elevated lipid levels during long-term infusions, [19][20][21][22] and risk of infection due to bacterial contamination. [23][24][25] Propofol is also associated with dose-dependent apnea and hemodynamic depression. 1,26 Following i.v.…”

Section: Introductionmentioning

confidence: 99%

Hemodynamic Profile in Rabbits of Fospropofol Disodium Injection Relative to Propofol Emulsion Following Rapid Bolus Injection

McIntosh

Iwasawa

Rajewski

et al. 2012

Journal of Pharmaceutical Sciences

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Section: Introductionmentioning

confidence: 99%

Hemodynamic Profile in Rabbits of Fospropofol Disodium Injection Relative to Propofol Emulsion Following Rapid Bolus Injection

McIntosh

Iwasawa

Rajewski

et al. 2012

Journal of Pharmaceutical Sciences

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“…coli (ATCC 25922) or P. aeruginosa (ATCC 27853) was not affected by pH 5.0 to 8.0 17 . In some studies the pH range of midazolam was thought to be responsible for the inhibitor effect 18,19 . On the other hand, in another study it is concluded that the antimicrobial effect of midazolam was due to the fact that it included HCl as a preservative 5 .…”

Section: Discussionmentioning

confidence: 99%

Antimicrobial Effects of Two Anaesthetic Agents: Dexmedetomidine and Midazolam

Ayoğlu

Külah

Turan

2008

Anaesth Intensive Care

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Some anaesthetic agents are known to inhibit microbial growth. The aim of this in vitro study was to investigate possible antimicrobial effects of two frequently used agents in intensive care units, dexmedetomidine and midazolam. Antimicrobial effect was tested on Staphylococcus aureus, Enterococcus faecalis, Escherichia coli and Pseudomonas aeruginosa by broth microdilution method. Midazolam showed inhibitor and bactericidal effect on S. aureus at concentrations 256 μg.ml-1 and 512 μgml-1 respectively and on E. faecalis at concentrations 128 μg.ml1 and 256 μg.ml-1. Dexmedetomidine demonstrated inhibitor effect on S. aureus, E. coli and P. aeruginosa at concentrations 32 μg.ml-1, 16 μg.ml-1 and 16 μg.ml-1 respectively. Midazolam had inhibitor and bactericidal effects on S. aureus and E. faecalis. Dexmedetomidine had only inhibitor effects on S. aureus, E. coli and P. aeruginosa. Further studies are needed to determine the antimicrobial mechanisms and clinical applications.

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“…Dagegen konnte die Arbeitsgruppe um Vidovich überhaupt keinen Effekt von Lidocain auf das Keimwachstum in Propofol nachweisen [122]. EDTA ist in einer Konzentration von 0,005 Gew-% in der Lage, die Vermehrung von Keimen sehr wirksam zu verhindern [14,39].Seit 1996 ist in den USA deshalb nur noch die Verwendung von Propofol mit diesem EDTA-Zusatz gestattet.Danach sind dort keine weiteren Infektionsfälle mehr bekannt geworden.…”

Section: Infektionsrisiko Durch Kontaminiertes Propofol Edta-zusatzunclassified

Total intraven�se An�sthesie

Strauß

Giest

2003

Der Anaesthesist

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Since venous cannulation in children has become easier and extensive experience has been gained with total intravenous anaesthesia (TIVA) in adults, the interest in TIVA for children has recently increased. An intensified sensitivity of the operating room atmosphere to contamination with volatile anaesthetic agents is another important reason to choose intravenous techniques for paediatric anaesthesia. One of the most interesting agents for TIVA in paediatric anaesthesia is propofol. The pharmacokinetic and pharmacodynamic data for modern intravenous drugs is poor. Because the interpatient variability is relatively large, pharmacokinetic data can only provide guidelines for the dosage of propofol. Propofol has a rapid and smooth onset of action and is as easy to titrate in children as in adults. Propofol can be excellently controlled. Severe haemodynamic side-effects are missing in healthy children and plasma is cleared rapidly of propofol by redistribution and metabolism. There is no evidence of significant accumulation, not even after prolonged infusion times. Because propofol has no analgetic properties it must be combined with analgetics or a regional block for all painful procedures. The combination with the ultra-short acting remifentanil is a major advantage, but requires effective analgetic concepts for painful procedures. In comparison the combination of propofol with long acting opioids abolishes some of the favourable properties of propofol. Further studies of the kinetics and dynamics of propofol and other intravenous agents are needed in paediatrics which should focus on age, maturity and severity of illness. The whole importance of the propofol-infusion syndrome has to be cleared up urgently. TIVA has an important significance in paediatric anaesthesia for diagnostic and therapeutic procedures, especially where these have to be repeated. In day-case anaesthesia TIVA has advantages for all short procedures and for ENT and ophthalmic surgery: even after prolonged infusion children have an short recovery time. There is no evidence of agitation or other behavioural disorders after TIVA with propofol in paediatric anaesthesia. Propofol has anti-emetic properties. TIVA with propofol can be combined with regional anaesthesia advantageously to provide long-lasting analgesia after surgery. TIVA with propofol has been used successfully for sedation of spontaneously breathing children for MRI and CT and other procedures with open airways like bronchoscopy or endoscopy. Propofol facilitates endotracheal intubation without the use of muscle relaxants. Of course, in malignant hyperthermia TIVA will continue to be the technique of choice. Nothing is known about awareness under TIVA in paediatric patients. TIVA must be considered by comparison with the volatile agents. The use of ultra-short acting agents may cause problems such as awareness, vagal response, involuntary movements and in some cases slow recovery after prolonged infusion of propofol. But it is not known exactly how often this happens during paediatri...

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Do Intensive Care Drug Infusions Support Microbial Growth?

Cited by 33 publications

References 16 publications

Hemodynamic Profile in Rabbits of Fospropofol Disodium Injection Relative to Propofol Emulsion Following Rapid Bolus Injection

Hemodynamic Profile in Rabbits of Fospropofol Disodium Injection Relative to Propofol Emulsion Following Rapid Bolus Injection

Antimicrobial Effects of Two Anaesthetic Agents: Dexmedetomidine and Midazolam

Total intraven�se An�sthesie

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