propofol infusion syndrome uptodate
The median time from the start of propofol therapy to identification of hypertriglyceridemia was 54 hours (range 14-319 hrs). An uncommon but potentially deadly complication of prolonged or high-dose propofol infusion, as well as high-dose short-term propofol infusions, PRIS is characterized by metabolic acidosis, hyperlipidemia, and cardiovascular collapse. The common side effects of propofol include pain on injection, hypotension, bradycardia, decreased cardiac output, hyperlipemia, and hypertriglyceridemia. Ketamine as an adjunctive antiepileptic agent The inclusion criteria for PRIS were continuous propofol infusion followed by development of metabolic acidosis and cardiac dysrhythmia with the addition of rhabdomyolysis, hypertriglyceridemia, or renal failure. Certain risk factors for the development of propofol infusion syndrome are described, such as appropriate propofol doses and durations of administration, carbohydrate depletion, severe illness, and concomitant administration of catecholamines and glucocorticosteroids. The authors stated: “Our observations support the recommendation to avoid using propofol in patients with known mitochondrial diseases.” Au contraire! INCIDENCE Because the definition of PRIS has not been standard-ized, the exact incidence of propofol infusion syndrome is unclear. "Propofol infusion syndrome continues to be refuted by AstraZeneca, the manufacturer," Dr. Schroeppel said. Even short-term propofol related infusion syndrome for surgical anaesthesia have been associated with development of metabolic acidosis. Propofol related infusion syndrome is a rare complication firstly reported in paediatric patients and also observed in adults, produced due to prolonged (>48 h) high doses of propofol (>66 mcg/kg/min) intravenous infusion.. propofol should be replaced every twelve hours (3). 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. Propofol infusion syndrome is a rare but extremely dangerous complication of propofol administration. 2007 Jul;62(7):690-701. Review. PMID: 19412155 2009 May;75(5):339-44. Propofol infusion syndrome is a rare but extremely dangerous complication of propofol administration. Fudickar A, Bein B. Propofol infusion syndrome: update of clinical manifestation and pathophysiology. This may be avoided by using propofol infusion rates below 83 mcg/kg/min (<5 mg/kg/hr) and serial monitoring of triglyceride levels (4). 4,5 Propofol is an ultra-short-acting I.V. 1: Kam PC, Cardone D. Propofol infusion syndrome. Savard et al.1 described a case of propofol-infusion syndrome (PRIS) heralding an occult case of mitochondrial disease. PubMed PMID: 17567345. Minerva Anestesiol. At the time when hypertriglyceridemia was detected, the median infusion rate of propofol was 50 microg/kg/minute (range 5-110 microg/kg/min). "As a matter of fact, in a paper published in 2006, [the … Anaesthesia. Prolonged infusion of propofol at high rates can cause propofol infusion syndrome (a highly morbid condition involving bradycardia, lactic acidosis, and shock).