Objective: To measure the impact of a national propofol shortage on the duration of mechanical ventilation.

Design: Before–after study.

Setting: Three, noncardiac surgery, adult intensive care units at a 320-bed academic medical centre in the NE United States.

Patients: Consecutive patients requiring mechanical ventilation for 48 hours or longer, administered a continuously infused sedative for 24 hours or longer, extubated, and successfully discharged from the intensive care unit were compared between before (1 Dec 2008 to 31 May 2009) and after (1 Dec 2009, to 31 May 2010) a propofol shortage.

Intervention: None.

Measurements and Main Results: Sedation drug use and common factors affecting time on mechanical ventilation were collected and if found either to differ significantly (p less than 0.10) between the two groups or to have an unadjusted significant association (p less than 0.10) with time on mechanical ventilation were included in a multivariable model.  The unadjusted analyses revealed that the median (interquartile range) duration of mechanical ventilation increased from 6.7 (9.8; n = 153) to 9.6 (9.5; n = 128) days (p = 0.02).  Fewer after-group patients received 24 hours or longer of continuously infused propofol (94% vs 15%, p less than 0.0001); more received 24 hours or longer of continuously infused lorazepam (7% vs 15%, p = 0.037) and midazolam (30% vs 81%, p less than 0.0001).  Compared with the before group, the after group was younger, had a higher admission Acute Physiology and Chronic Health Evaluation (APACHE) II score, was more likely to be admitted by a surgical service, have acute alcohol withdrawal and be managed with pressure-controlled ventilation as the primary mode of mechanical ventilation.  Of these five factors, only the APACHE II score, admission service and use of a pressure-controlled ventilation affected duration of mechanical ventilation across both groups.  Although a regression model revealed that APACHE II score (p less than 0.0001), admission by a medical service (p = 0.009) and use of pressure-controlled ventilation (p = 0.02) each affected duration of mechanical ventilation in both groups, inclusion in either the before- or after-propofol shortage groups (i.e. high vs low use of propofol) did not affect duration of mechanical ventilation (p = 0.35).

Conclusions: An 84% decrease in propofol use in the adult intensive care units at our academic institution as a result of a national shortage did not affect duration of mechanical ventilation.