Using Propofol for sedation on vented pts?

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Is Propofol used on vented patients? Since the half-life of Propofol is so short wouldn't it be more justified using a longer activing sedative? I assume that Propofol isn't used for long-term vented pts right? Maybe just initially?

I'm still in school so I have no experience with any of this other than what I hear or see, so thanks for any responses. I was just curious.

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Yes it is used for short term sedation for ventilated patients. The half life is very short so the pt receives a continuous IV drip. It does wear off fast.

It depends on how long term you are talking (2 weeks or years) but generally if you are intubated orally or nasally for longer than 2 weeks they put a trach in. Once they put a trach in as long as your condition is stablized or improving they will cut the sedation off.

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Specializes in Nurse Anesthesia, ICU, ED.

The "beauty" of propofol is the short half-life and the rapid onset. So, if a pt needs a sedation vacation, he comes off quick and if the pt fights too much can be put down quickly.

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Pretty much we use propofol exclusively. It's a great drug when used properly. And the short half-life is one of the properties that make it excellent for sedation in the unit.

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Thanks

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Specializes in post surgical, tele, icu.

some docs will use versed for patients who aren't coming off the vent any time soon. Vitamin D is your best friend in the ICU though. It takes a massive amount of it to max out on dosage as well. I've noticed a lot of docs don't place people on any pain meds when sedated, and propofol doesn't do anything for pain. I need to find research on this cause it often falls on deaf ears.

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Vitamin D? Are you refering to diazepam? Dilaudid? demerol?

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Specializes in ICU.

I am assuming Vitamin D is diprivan which is propofol, although I have not heard that before.

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Specializes in Cardiac.

We use Propofol all the time, and I love it! We use it with Fentanyl for a lovely combo.

I prefer Propofol for all the reasons listed above. If things get hairy, I can quickly titrate up, and if they need a quick sedation vacation, then it goes off.

Never heard of it being called Vitamin D...

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Specializes in Nurse Anesthesia, ICU, ED.

best name-"milk of amnesia"

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Specializes in ICU/ER/TRANSPORT.

In the past we've used everything from a versed gtt to dilauded iv pushes prn for sedation. But within the last 2yrs since we got a "Hardcore" pulm. doc he really likes using the diprovan gtts. When we started using the drug more often our unit director got one anesth. doc's to come an give us a little walk through class about the drug, what to look for, contraindications and initial titration/bolus of the drug. I've become very found of the drug for it's rapid onset and mostly for rapid short acting halflife, granted if you have'nt been on it at 200mcgs for a month. Our nutritionist like it for it's nutritional value as well, I think it has somewhere to the value of 1-1.5 calories/ml, some of you folks may know of a more specific range.

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It is a great drug for sedation for vented patients. Of course you have to be careful with the cardiac depression, and long term administration can lead to acidosis in children. Some of the other positives include bronchodilation and antiemetic properties (but we really don't worry about that for vented patients). It is known as a very clean drug, however, it is only good for six hours from opening, many studies have shown bacterial contamination after that expiration. So if you're running it at a very low rate (10-20 mcg/kg/min) with a very large bottle remember to change it. It can also be very irritating to the vein, but should not be mixed with lidocaine in the bottle. Long term administration may cause a longer awakening than you expect too.

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