Effect of Enteral Versus Parenteral Feeding on Hepatic Blood Flow and Steady State Propofol Pharmacokinetics in ICU Patients

Overview

Journal Intensive Care Med

Specialty Critical Care

Date 1998 Oct 3

PMID 9757923

Citations 2

Authors

N Van Brandt

P Hantson

Y Horsmans

P Mahieu

R K Verbeeck

Affiliations

Soon will be listed here.

Abstract

Objective: The main objective of this study was to evaluate the effect of switching from parenteral to enteral feeding on liver blood flow and propofol steady-state blood concentrations in patients in the intensive care unit (ICU).

Design And Patients: Steady-state blood concentrations of propofol were measured in eight ICU patients before (on days D -3, D -2, and D -1) and after (on days D + 1, D + 2, and D + 3) switching from parenteral to enteral feeding (on day DO). All patients received a continuous intravenous infusion of propofol (4.5 mg x kg(-1) x h(-1)) from several days before the start of the study, continuing throughout the experimental period. Hepatic blood flow was estimated by measuring steady-state D-sorbitol hepatic clearance.

Results: Hepatic blood flow was high and was not affected by switching from parenteral to enteral feeding: 33 +/- 8 ml x min(-1) x kg(-1) (mean +/- SD) and 33 +/- 10 ml min(-1) x kg(-1) on D -3 and D -1, respectively, as compared to 37 +/- 11 ml x min(-1) kg(-1) and 34 +/- 8 ml x min(-1) x kg(-1) on days D + 1 and D + 3, respectively. Systemic clearance of propofol was much higher than liver blood flow with average values on the six observation days ranging from 74.0 to 81.2 ml x min(-1) x kg(-1) and was not affected by switching from parenteral to enteral feeding.

Conclusions: Liver blood flow and systemic clearance of propofol were not affected by switching from parenteral to enteral feeding in the eight ICU patients studied. Extrahepatic clearance accounted for at least two thirds of the overall systemic clearance of propofol.

Citing Articles

Mini-series: I. Basic science. Uncertainty and inaccuracy of predicting CYP-mediated in vivo drug interactions in the ICU from in vitro models: focus on CYP3A4.

Mouly S, Meune C, Bergmann J Intensive Care Med. 2009; 35(3):417-29.

PMID: 19132343 DOI: 10.1007/s00134-008-1384-1.

Propofol: a review of its use in intensive care sedation of adults.

McKeage K, Perry C CNS Drugs. 2003; 17(4):235-72.

PMID: 12665397 DOI: 10.2165/00023210-200317040-00003.

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