Abstract Rationale Data on the hemodynamic effects, morbidity, and mortality outcomes of propofol in patients with Pulmonary Hypertension (PH) in the intensive care unit (ICU) is limited. Expert opinion recommends caution with intravenous (IV) propofol in patients with PH given the potential for right ventricle failure. We hypothesized that propofol administration to PH patients may adversely affect hemodynamics, length of stay, and mortality. Methods We retrospectively examined electronic medical records of WHO groups 1-5 PH patients admitted to an intensive care unit at Thomas Jefferson University Hospital between 2019-2025. The diagnosis of PH was verified by review of right heart catheterization (RHC) data. In cases wherein RHC data was unavailable, we used echocardiograms and Virtual Echocardiogram Screening Tool (VEST) to support the diagnosis of PH. Patients were separated into those who received propofol and those who did not. Analysis was conducted using t-test, Fisher’s Exact test, and Mann-Whitney U test. Results We included 33 cases, of which 22 received propofol. There was no statistically significant difference in age, sex, ethnicity, and presence of dilated right ventricle (RV) between the groups. At baseline, there was also no difference in the use of vasopressors, paralytics, and conjunct sedatives including fentanyl, dexmedetomidine, inhaled anesthetics, and midazolam. BMI was greater in the group receiving propofol (p = 0.01). The mean number of vasopressors used in the first 24 hours in the propofol group was 1.77 standard deviation (SD) 1.478, and 1.91(SD) 1.514 in the non-propofol group, p = 0.80. There was no statistically significant difference in the number of inotropes used in the first 24 hours in either group, p = 0.14. However, the proportion of cases in which inotropes were utilized within 24 hours was greater in the non-propofol group; 4/11 versus 3/22 in the propofol group. The distribution of ICU length of stay (LOS) in days, ventilator days, and hospital LOS was no different between the groups; p = 0.86, p = 0.74, and p = 0.56, respectively. A greater proportion of patients in the non-propofol group died within 28 days; 8/11 compared with 11/22, though not statistically significant. Conclusion Administration of IV propofol to PH patients in the ICU was not associated with greater vasopressor or inotrope utilization and was not associated with greater ICU length of stay, ventilator days, hospital length of stay or 28-day mortality. Notably, non-exposure to propofol showed a non-statistically significant trend toward greater mortality at 28 days. This abstract is funded by: None
Fakunle et al. (Fri,) studied this question.