---
title: "Safety of Concurrent Continuous Infusions of Propofol and Clevidipine in Critically Ill Adults"
id: "pubmed-42666011"
canonical_url: "https://medichelpline.com/clinical-feed/pubmed-42666011"
content_type: "clinical_feed_article"
specialty: "Critical Care"
source_name: "PubMed / NCBI"
source_url: "https://pubmed.ncbi.nlm.nih.gov/42666011/"
doi: "10.1002/phar.70196"
published_at: "2026-09-01T00:00:00.000Z"
evidence_level: "Journal Article"
license: "CC-BY-NC-4.0 / Informational Use"
---
# Safety of Concurrent Continuous Infusions of Propofol and Clevidipine in Critically Ill Adults
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/pubmed-42666011
- **Specialty:** [Critical Care](https://medichelpline.com/clinical-feed/critical-care.md)
- **Primary Source:** PubMed / NCBI
- **Source URL:** [Original Journal Publication](https://pubmed.ncbi.nlm.nih.gov/42666011/)
- **DOI:** [10.1002/phar.70196](https://doi.org/10.1002%2Fphar.70196)
- **Published At:** 2026-09-01T00:00:00.000Z
- **Evidence Rating:** Journal Article
## Executive GIST (TL;DR)
- This multicenter retrospective study evaluated adults (≥18 years) who received overlapping continuous infusions of **propofol** and **clevidipine** for at least 6 hours to assess the frequency of **hypertriglyceridemia** and **acute pancreatitis**. - The cohort included 1,226 patients with a median infusion overlap of 12.4 hours (IQR 8.3–22.7); mean age was 59.6 years and 59.4% were male. - Assuming missing triglyceride measurements indicated no hypertriglyceridemia, 7.7% (95% CI 6.3%–9.3%) met the primary triglyceride cutoff (>400 mg/dL) after starting both infusions. - Twenty-six patients (2.1%) were diagnosed with pancreatitis after initiation of lipid infusions; 13 cases were adjudicated as possibly or likely related to the infusions using the Naranjo Scale (12 possibly infusion-related, 1 likely infusion-related), and all 13 were categorized as possibly related after Naranjo scoring. - Multivariable logistic regression among patients with triglyceride data identified prior pancreatitis within 5 years (aOR 2.77, 95% CI 1.23–6.23) and baseline statin use (aOR 1.94, 95% CI 1.13–3.34) as independent risk factors for hypertriglyceridemia during coadministration. - Overall incidence of both hypertriglyceridemia and acute pancreatitis was low in this large cohort receiving concurrent lipid emulsions, though the authors call for further comparative studies to better define pancreatitis risk when clevidipine is added to propofol. - Keywords from the study include **propofol**, **clevidipine**, **lipid emulsion**, **hypertriglyceridemia**, **acute pancreatitis**, and **risk factors**.
## Clinical Analysis & Structured Key Points
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Affiliations Expand ### Affiliations * 1 Department of Pharmacy, Mayo Clinic, Rochester, Minnesota, USA. * 2 Division of Clinical Trials and Biostatistics, Mayo Clinic, Rochester, Minnesota, USA. * 3 Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA. * 4 Department of Emergency Medicine, Mayo Clinic, Rochester, Minnesota, USA. * 5 Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, Minnesota, USA. * 6 Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA. * PMID: **42666011** * PMCID: [ PMC13525345 ](https://pmc.ncbi.nlm.nih.gov/articles/PMC13525345/) * DOI: [ 10.1002/phar.70196 ](https://doi.org/10.1002/phar.70196) Item in Clipboard Multicenter Study # Safety of Coadministration of Continuous Infusions of Propofol and Clevidipine: A Multi-Site Retrospective Analysis Micaela N Warfield et al. Pharmacotherapy. 2026 Sep. Show details Display options Display options Format Abstract PubMed PMID Pharmacotherapy Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Pharmacotherapy%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22Pharmacotherapy%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42666011/) . 2026 Sep;46(9):e70196. doi: 10.1002/phar.70196. ### Authors [Micaela N Warfield](https://pubmed.ncbi.nlm.nih.gov/?term=Warfield+MN&cauthor_id=42666011)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42666011/#short-view-affiliation-1 "Department of Pharmacy, Mayo Clinic, Rochester, Minnesota, USA."), [Kristin C Cole](https://pubmed.ncbi.nlm.nih.gov/?term=Cole+KC&cauthor_id=42666011)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42666011/#short-view-affiliation-2 "Division of Clinical Trials and Biostatistics, Mayo Clinic, Rochester, Minnesota, USA."), [Kiyan Heybati](https://pubmed.ncbi.nlm.nih.gov/?term=Heybati+K&cauthor_id=42666011)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42666011/#short-view-affiliation-3 "Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA."), [Nicholas J Vollmer](https://pubmed.ncbi.nlm.nih.gov/?term=Vollmer+NJ&cauthor_id=42666011)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42666011/#short-view-affiliation-1 "Department of Pharmacy, Mayo Clinic, Rochester, Minnesota, USA."), [Erin D Wieruszewski](https://pubmed.ncbi.nlm.nih.gov/?term=Wieruszewski+ED&cauthor_id=42666011)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42666011/#short-view-affiliation-1 "Department of Pharmacy, Mayo Clinic, Rochester, Minnesota, USA.")[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42666011/#short-view-affiliation-4 "Department of Emergency Medicine, Mayo Clinic, Rochester, Minnesota, USA."), [Hemang Yadav](https://pubmed.ncbi.nlm.nih.gov/?term=Yadav+H&cauthor_id=42666011)[ 5 ](https://pubmed.ncbi.nlm.nih.gov/42666011/#short-view-affiliation-5 "Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, Minnesota, USA."), [Alejandro A Rabinstein](https://pubmed.ncbi.nlm.nih.gov/?term=Rabinstein+AA&cauthor_id=42666011)[ 6 ](https://pubmed.ncbi.nlm.nih.gov/42666011/#short-view-affiliation-6 "Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA."), [Caitlin S Brown](https://pubmed.ncbi.nlm.nih.gov/?term=Brown+CS&cauthor_id=42666011)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42666011/#short-view-affiliation-1 "Department of Pharmacy, Mayo Clinic, Rochester, Minnesota, USA.")[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42666011/#short-view-affiliation-4 "Department of Emergency Medicine, Mayo Clinic, Rochester, Minnesota, USA.") ### Affiliations * 1 Department of Pharmacy, Mayo Clinic, Rochester, Minnesota, USA. * 2 Division of Clinical Trials and Biostatistics, Mayo Clinic, Rochester, Minnesota, USA. * 3 Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA. * 4 Department of Emergency Medicine, Mayo Clinic, Rochester, Minnesota, USA. * 5 Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, Minnesota, USA. * 6 Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA. * PMID: **42666011** * PMCID: [ PMC13525345 ](https://pmc.ncbi.nlm.nih.gov/articles/PMC13525345/) * DOI: [ 10.1002/phar.70196 ](https://doi.org/10.1002/phar.70196) Item in Clipboard Full text links Cite Display options Display options Format Abstract PubMed PMID ## Abstract **Introduction:** Patients often receive propofol for sedation and clevidipine for hypertension in the intensive care unit. Both agents are formulated as a lipid emulsion, which may increase the risk of hypertriglyceridemia and acute pancreatitis with their coadministration. We aimed to determine the incidence of hypertriglyceridemia and acute pancreatitis with concurrent administration of propofol and clevidipine and identify patient risk factors for hypertriglyceridemia. **Methods:** This was a multicenter retrospective study of adult patients (≥ 18 years old) receiving concurrent propofol and clevidipine infusions for ≥ 6 h. The primary outcome was the frequency of triglyceride levels greater than 400 mg/dL and acute pancreatitis. The secondary outcome was risk factors associated with hypertriglyceridemia during concurrent propofol and clevidipine infusions until both infusions had been discontinued. Univariable and multivariable logistic regression analyses were used to assess risk factors of hypertriglyceridemia in patients receiving concurrent propofol and clevidipine infusions. **Results:** Across 1,226 patients, the median duration of infusion overlap was 12.4 [interquartile range (IQR) 8.3, 22.7] hours. The mean age of the cohort was 59.6 [standard deviation (SD) 14.9] years, and 59.4% were male. Assuming those without a triglyceride level drawn did not have hypertriglyceridemia, hypertriglyceridemia after initiation of propofol and clevidipine infusion was found in 7.7% [95% confidence interval (CI) 6.3% to 9.3%] of the entire cohort. Twenty-six patients (2.1%) had a diagnosis of pancreatitis after initiation of lipid infusions, of which 12 cases were possibly infusion-related, and one case was likely infusion-related. After calculating the Naranjo Scale, all 13 cases of pancreatitis were possibly related to propofol or clevidipine infusions. Based on a multivariable logistic regression of those with a triglyceride level available, risk factors for hypertriglyceridemia included pancreatitis within the past 5 years [adjusted odds ratio (aOR) 2.77, 95% CI, 1.23 to 6.23] and statin use (aOR 1.94, 95% CI, 1.13 to 3.34). **Conclusions:** In our cohort of patients receiving concurrent propofol and clevidipine, the frequency of hypertriglyceridemia and acute pancreatitis was low. Further comparative studies are warranted to assess the risk of pancreatitis with the addition of clevidipine to propofol. **Keywords:** acute pancreatitis; clevidipine; hypertriglyceridemia; lipid emulsion; propofol; risk factors. © 2026 ACCP Foundation, Ltd. [PubMed Disclaimer](https://pubmed.ncbi.nlm.nih.gov/disclaimer/) ## Conflict of interest statement The authors have nothing to report. A.R. previously served on the Advisory Board for Chiesi and currently serves on the Clinical Events Adjudication Committee for Boston Scientific and Boehringer Ingelheim. ## Figures [ ![FIGURE 1](https://cdn.ncbi.nlm.nih.gov/pmc/blobs/acbe/13525345/e9aa4d94f065/PHAR-46-0-g001.gif) ](https://cdn.ncbi.nlm.nih.gov/pmc/blobs/acbe/13525345/63de48409f81/PHAR-46-0-g001.webp) ** FIGURE 1 ** Patient cohort CONSORT diagram. ** FIGURE 1 ** Patient cohort CONSORT diagram. **FIGURE 1** Patient cohort CONSORT diagram. [ ![FIGURE 2](https://cdn.ncbi.nlm.nih.gov/pmc/blobs/acbe/13525345/22c9a1fe71ec/PHAR-46-0-g003.gif) ](https://cdn.ncbi.nlm.nih.gov/pmc/blobs/acbe/13525345/d786098ceb25/PHAR-46-0-g003.webp) ** FIGURE 2 ** Histogram and boxplot depicting the… ** FIGURE 2 ** Histogram and boxplot depicting the time from initiation of concurrent propofol‐clevidipine administration to… **FIGURE 2** Histogram and boxplot depicting the time from initiation of concurrent propofol‐clevidipine administration to the time of hypertriglyceridemia among those who had hypertriglyceridemia (_n_ = 94). [ ![FIGURE 3](https://cdn.ncbi.nlm.nih.gov/pmc/blobs/acbe/13525345/c51ec44b4d2b/PHAR-46-0-g002.gif) ](https://cdn.ncbi.nlm.nih.gov/pmc/blobs/acbe/13525345/22ce1b4442ed/PHAR-46-0-g002.webp) ** FIGURE 3 ** Incidence curves representing percent of… ** FIGURE 3 ** Incidence curves representing percent of patients with any pancreatitis on each day following… **FIGURE 3** Incidence curves representing percent of patients with any pancreatitis on each day following initiation of clevidipine‐propofol combination (black line) and percent of pancreatitis cases related to propofol or clevidipine on each day following initiation of clevidipine‐propofol combination (gray line) along with the respective 95% confidence intervals. [ ![FIGURE 4](https://cdn.ncbi.nlm.nih.gov/pmc/blobs/acbe/13525345/7d83ebdc8735/PHAR-46-0-g004.gif) ](https://cdn.ncbi.nlm.nih.gov/pmc/blobs/acbe/13525345/8e2cfacaa8ef/PHAR-46-0-g004.webp) ** FIGURE 4 ** Scatter plot depicting the impact… ** FIGURE 4 ** Scatter plot depicting the impact of increasing doses of propofol (left) and clevidipine… **FIGURE 4** Scatter plot depicting the impact of increasing doses of propofol (left) and clevidipine (right) on triglyceride serum concentrations. Lighter gray circles represent lower doses of propofol and clevidipine, and darker gray circles represent higher doses of propofol and clevidipine. The dashed blue line represents the triglyceride cutoff of 400 mg/dL. The red line represents the linear fit of the data. [See this image and copyright information in PMC](https://pubmed.ncbi.nlm.nih.gov/42666011/) ## Similar articles * [ Propofol, Triglycerides, and Acute Pancreatitis: A Multicenter Epidemiologic Analysis. ](https://pubmed.ncbi.nlm.nih.gov/39393346/) Heybati K, Deng J, Xie G, Poudel K, Zhou F, Rizwan Z, Brown CS, Acker CT, Gajic O, Yadav H.Heybati K, et al.Ann Am Thorac Soc. 2025 Feb;22(2):235-246. doi: 10.1513/AnnalsATS.202407-781OC.Ann Am Thorac Soc. 2025.PMID: 39393346Free PMC article. * [ Propofol-associated hypertriglyceridemia and pancreatitis in the intensive care unit: an analysis of frequency and risk factors. ](https://pubmed.ncbi.nlm.nih.gov/16185179/) Devlin JW, Lau AK, Tanios MA.Devlin JW, et al.Pharmacotherapy. 2005 Oct;25(10):1348-52. doi: 10.1592/phco.2005.25.10.1348.Pharmacotherapy. 2005.PMID: 16185179 * [ Propofol and Clevidipine-induced Hypertriglyceridemia. ](https://pubmed.ncbi.nlm.nih.gov/30357028/) Kaur H, Nattanamai P, Qualls KE.Kaur H, et al.Cureus. 2018 Aug 20;10(8):e3165. doi: 10.7759/cureus.3165.Cureus. 2018.PMID: 30357028Free PMC article. * [ Clev
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