To the Editor.—

Ghanta et al reported that in preterm infants (median gestational age: 27–28 weeks; median postnatal age: 3–4 days), the use of propofol is more effective than a morphine, atropine, and suxamethonium regimen as an induction agent to facilitate neonatal nasal endotracheal intubation. In their well-designed randomized, controlled clinical trial, they used a single 2.5 mg/kg intravenous dose and based their selection of this specific dose on the recommended lowest bolus induction dose for propofol in adults and children >3 years old. As a neonatal clinical pharmacologist, I would like to know the rationale behind the selection of this specific dose for use in this vulnerable population without having any information on the pharmacokinetics of propofol in the studied population. Propofol is a highly lipophilic compound that exhibits a rapid distribution from the vascular compartment into the fat compartment including the central nervous system followed by...

You do not currently have access to this content.