Despite the risk of propofol infusion syndrome, a rare but often fatal 
complication of propofol infusion in ventilated children and possibly adults, 
propofol infusion remains in use in paediatric intensive care units (PICU). This 
questionnaire study surveys the current pattern of use of this sedative infusion 
in Australian and New Zealand PICUs. Thirty-three of the 45 paediatric intensive 
care physicians surveyed (73%), from 12 of the 13 intensive care units, returned 
completed questionnaires. The majority of practitioners (82%) use propofol 
infusion in children in PICU, the main indication being for short-term sedation 
in children requiring procedures. 39% of respondents consider propofol infusion 
useful in ventilated children requiring longer-term sedation. 67% of paediatric 
intensivists use maximum infusion doses that may be considered dangerously high 
(> or = 10 mg/kg/h). Nineteen per cent use propofol infusion for prolonged 
periods (> 72 hours). A smaller proportion (15%) of respondents indicate that 
they may use both higher doses and prolonged periods of infusion, a practice 
likely to lead to a greater chance of serious adverse events. Knowledge of local 
protocols for the use of propofol infusion is associated with a significantly 
greater level of monitoring for possible adverse events. We suggest that 
national guidelines for the use of propofol infusion in children should be 
developed. These should include clear indications and contraindications to its 
use, a maximum dose rate and maximum period of infusion, with a ceiling placed 
on the cumulative dose given and clearly stated minimum monitoring requirements.