Propofol Clearance and Volume of Distribution Are Increased in Patients With Major Burns

被引：11
作者：
Han, Tae-Hyung [1 ]
Greenblatt, David J. [2 ,3 ]
Martyn, J. A. Jeevendra [4 ,5 ]
机构：
[1] Univ Iowa, Hosp & Clin, Dept Anesthesia, Roy J & Lucille A Carver Coll Med, Iowa City, IA 52242 USA
[2] Tufts Univ, Sch Med, Dept Pharmacol & Expt Therapeut, Boston, MA 02111 USA
[3] Tufts Med Ctr, Boston, MA USA
[4] Harvard Univ, Massachusetts Gen Hosp, Sch Med, Dept Anesthesiol & Crit Care, Boston, MA USA
[5] Shriners Hosp Children, Boston, MA USA
来源：
JOURNAL OF CLINICAL PHARMACOLOGY | 2009年 / 49卷 / 07期
关键词：
Cardiac index; hepatic blood flow; hypnotics; pharmacokinetics; CARDIAC-OUTPUT; THERMAL-INJURY; PHARMACOKINETICS; INFUSION; CHILDREN; SHOCK; PHARMACODYNAMICS; CIMETIDINE; PLASMA; MODEL;
D O I：
10.1177/0091270009335767
中图分类号：
R9 [药学];
学科分类号：
1007 ;
摘要：
Propofol pharmacokinetics were examined in 17 adults with major burns during the hyperdynamic convalescent phase. Eighteen nonburned surgical patients served as controls. After a 2-mg/kg intravenous dose of propofol, blood samples were collected at multiple time points. Noncompartmental methods were used to calculate the pharmacokinetic parameters. The following indices were higher in burns than controls: propofol clearance (64 +/- 17 vs 29 +/- 4 mL/kg/min, P < .001) and volume of distribution (8 +/- 3 vs 4 +/- 1 L/kg, P < .001). The area under the curve was smaller in burns (556 +/- 152 vs 1193 +/- 183 mu g/mL h, P < .001). The higher clearance of propofol in burned patients may imply that these patients require higher doses or infusion rates of propofol to attain a target plasma concentration or pharmacodynamic effect.
引用
收藏
页码：768 / 772
页数：5
相关论文
共 33 条
[1]   USE OF DIPRIVAN(R) IN THE BURNED PATIENT [J].
CARSIN, H .
ANNALES FRANCAISES D ANESTHESIE ET DE REANIMATION, 1994, 13 (04) :541-544
[2]   LONG-TERM HIGH-DOSE MORPHINE, KETAMINE AND MIDAZOLAM INFUSION IN A CHILD WITH BURNS [J].
CEDERHOLM, I ;
BENGTSSON, M ;
BJORKMAN, S ;
CHOONARA, I ;
RANE, A .
BRITISH JOURNAL OF CLINICAL PHARMACOLOGY, 1990, 30 (06) :901-905
[3]  
COTE CJ, 1985, ANESTH ANALG, V64, P1156
[4]   Cytochrome P-4502B6 is responsible for interindividual variability of propofol hydroxylation by human liver microsomes [J].
Court, MH ;
Duan, SX ;
Hesse, LM ;
Venkatakrishnan, K ;
Greenblatt, DJ .
ANESTHESIOLOGY, 2001, 94 (01) :110-119
[5]   Pharmacokinetic and pharmacodynamic considerations when treating patients with sepsis and septic shock [J].
De Paepe, P ;
Belpaire, FM ;
Buylaert, WA .
CLINICAL PHARMACOKINETICS, 2002, 41 (14) :1135-1151
[6]   Influence of hypovolemia on the pharmacokinetics and the electroencephalographic effect of propofol in the rat [J].
De Paepe, P ;
Belpaire, FM ;
Rosseel, MT ;
Van Hoey, G ;
Boon, PA ;
Buylaert, WA .
ANESTHESIOLOGY, 2000, 93 (06) :1482-1490
[7]  
Galizia J P, 1989, Ann Fr Anesth Reanim, V8 Suppl, pR157
[8]   Fentanyl clearance and volume of distribution are increased in patients with major burns [J].
Han, Taehyung ;
Harmatz, Jerold S. ;
Greenblatt, David J. ;
Martyn, J. A. Jeevendra .
JOURNAL OF CLINICAL PHARMACOLOGY, 2007, 47 (06) :674-680
[9]   The relationship between bispectral index and targeted propofol concentration is biphasic in patients with major burns [J].
Han, TH ;
Lee, JH ;
Kwak, IS ;
Kil, HY ;
Han, KW ;
Kim, KM .
ACTA ANAESTHESIOLOGICA SCANDINAVICA, 2005, 49 (01) :85-91
[10]   Kidneys contribute to the extrahepatic clearance of propofol in humans, but not lungs and brain [J].
Hiraoka, H ;
Yamamoto, K ;
Miyoshi, S ;
Morita, T ;
Nakamura, K ;
Kadoi, Y ;
Kunimoto, F ;
Horiuchi, R .
BRITISH JOURNAL OF CLINICAL PHARMACOLOGY, 2005, 60 (02) :176-182
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