ICU SEDATION: PROPOFOL *only for patients with an advanced airway #icu #sedation #propofol

Added: 2026-05-27

[00:00:00]Let's talk about sedation in the ICU and more specifically let's talk about propall. Now propall has a very classic milk-like appearance and the reason for that is it actually comes in a lipid emulsion. Now the reason we like to use propall in the intensive care unit is because of its rapid onset takes about a minute to start working and also its rapid offset. it wears out of the system very quickly even in patients with renal disease and that can be super helpful especially when you're trying to assess someone's mental status or their readiness for extation it does take a little bit longer to clear out propal in patients who have advanced hypatic disease or hypatic failure now aside from that how does propal even work now propall works by acting on the GABA receptors which are inhibitory neurotransmitters in the brain some other helpful properties of propal is that it has anti- convulsant properties.

[00:00:53]So, it can be really helpful in patients with refractory seizures. It also has some bronco dilator effects. Now, let's talk about the cons of using propall.

[00:01:02]Now, like we said, it comes in a lipid emulsion. So, that can be quite a few calories and also quite a few triglycerides. And one of the things you have to look out for is those high triglycerides causing pancreatitis.

[00:01:14]Another thing to look out for is hypotension. Now when you bowl as propall if you choose to do so you will almost certainly see a big drop in your blood pressure and you have to be prepared for that with your vasopressors fluids etc. Sometimes people worry when they see green urine in patients on propall but that's actually a totally benign finding that's just related to the breakdown product of propyl. Last but not least, you should be aware that there's something called propyl infusion syndrome. And this is a very rare but deadly syndrome. And it's more likely to occur in patients who are on propall at high doses for a long period of time.

[00:01:50]What we're looking at with propyl infusion syndrome is the hyper triglyceridemia, metabolic acidosis, renal failure, rabdtomyalysis, hypercalemia, and eventually Death.