• T J Parke, J E Stevens, A S Rice, C L Greenaway, R J Bray, P J Smith, C S Waldmann, and C Verghese.
• Nuffield Department of Anaesthetics, John Radcliffe Hospital, Oxford.
• BMJ. 1992 Sep 12; 305 (6854): 613-6.

ObjectiveTo examine the possible contribution of sedation with propofol in the deaths of children who were intubated and required intensive care.DesignCase note review.SettingThree intensive care units.SubjectsFive children with upper respiratory tract infections aged between 4 weeks and 6 years.ResultsFour patients had laryngotracheo-bronchitis and one had bronchiolitis. All were sedated with propofol. The clinical course in all five cases was remarkably similar: an increasing metabolic acidosis was associated with brady-arrhythmia and progressive myocardial failure, which did not respond to resuscitative measures. All children developed lipaemic serum after starting propofol. These features are not usually associated with respiratory tract infections. No evidence was found of viral myocarditis, which was considered as a possible cause of death.ConclusionAlthough the exact cause of death in these children could not be defined, propofol may have been a contributing factor.

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