Serum protein binding of propofol in critically ill patients

Acta Anaesthesiologica Scandinavica
M K ZamaconaR Calvo

Abstract

Disease-induced modifications in the level of serum proteins may change the degree of binding of drugs highly bound to serum proteins. The serum protein binding of propofol, an intravenous anaesthetic agent was studied in vitro in samples of serum from healthy volunteers (n=28) and from critically ill patients (n=17). The free fraction was obtained by the ultrafiltration technique and was measured by high-performance liquid chromatography. Concentrations of serum albumin, alpha1-acid-glycoprotein and free fatty acids were also measured in all samples. The percentage of free propofol was significantly increased (P<0.001) in critically ill patients (1.31 (1.06-2.25)%) vs control subjects (1.07 (0.49-1.47)%). Albumin levels were significantly decreased (P<0.001) in patients (16.3 (8.8-24.6) g x l(-1) vs 45.8 (31.4-55.5) g x l[-1]), while levels of alpha1-acid-glycoprotein were increased (P<0.001) (1.9 (0.9-2.8) g x l(-1) vs 0.9 (0.5-1.4) g x l[-1]), as were levels of free fatty acids (0.68 (0.50-1.14) mmol x l(-1) vs 0.37 (0.11-1.05) mmol x l(-1); P<0.05 ). No correlation was found between levels of alpha1-acid-glycoprotein or free fatty acids and the bound/free ratio of propofol. However, a linear relationship was found between l...Continue Reading

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Citations

Apr 12, 2000·British Journal of Clinical Pharmacology·E SuarezJ Lukas
Jun 11, 2004·Clinical Neuropharmacology·Andrzej L DawidowiczAnna Fijalkowska
Nov 7, 1998·Anesthesia and Analgesia·M K ZamaconaR Calvo
Oct 23, 2010·International Heart Journal·Tadanobu IrieMasahiko Kurabayashi
Oct 31, 2002·Clinical Pharmacokinetics·Peter De PaepeWalter A Buylaert
Aug 19, 2004·Acta Anaesthesiologica Scandinavica·R CalvoJ C Lukas
Oct 9, 2008·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Alexandre P ZavasckiJian Li
Nov 27, 2002·Therapeutic Drug Monitoring·Leire de la FuenteElena Suárez
Dec 9, 2017·Expert Review of Clinical Pharmacology·Ricard FerrerJosé Garnacho-Montero
Feb 15, 2019·Journal of Intensive Care Medicine·Kathryn RosenblattPaul Nyquist
Apr 12, 2000·British Journal of Clinical Pharmacology·J X Mazoit, K Samii

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