Propofol infusion syndrome

Propofol infusion syndrome (PRIS) is a rare syndrome which affects patients undergoing long-term treatment with high doses of the anaesthetic and sedative drug propofol. It can lead to cardiac failure, rhabdomyolysis, metabolic acidosis, and kidney failure, and is often fatal.[1][2][3] High blood potassium, high blood triglycerides, and liver enlargement, proposed to be caused by either "a direct mitochondrial respiratory chain inhibition or impaired mitochondrial fatty acid metabolism" [4] are also key features. It is associated with high doses and long-term use of propofol (> 4 mg/kg/h for more than 24 hours). It occurs more commonly in children, and critically ill patients receiving catecholamines and glucocorticoids are at high risk. Treatment is supportive. Early recognition of the syndrome and discontinuation of the propofol infusion reduces morbidity and mortality.

References

  1. ↑ Vasile, Vasile B; Rasulo F; Candiani A; Latronico N. (September 2003). "The pathophysiology of propofol infusion syndrome: a simple name for a complex syndrome.". Intensive Care Medicine 29 (9): 1417–25. doi:10.1007/s00134-003-1905-x. PMID 12904852.
  2. ↑ Zaccheo, Melissa M; Bucher, Donald H. (June 2008). "Propofol Infusion Syndrome: A Rare Complication With Potentially Fatal Results.". Critical Care Nurse 28 (3): 18–25. PMID 18515605.
  3. ↑ Sharshar, T. (2008). "[ICU-acquired neuromyopathy, delirium and sedation in intensive care unit]". Ann Fr Anesth Reanim 27 (7-8): 617–22. doi:10.1016/j.annfar.2008.05.010. PMID 18584998.
  4. ↑ Kam, PC; Cardone D. (July 2007). "Propofol infusion syndrome.". Anaesthesia 62 (7): 690–701. doi:10.1111/j.1365-2044.2007.05055.x. PMID 17567345.


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