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Propofol Infusion Syndrome

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Propofol Infusion Syndrome

  • See Also
  1. Propofol
  2. Fospropofol
  • Epidemiology
  1. ICU patients (most common)
  2. Patients on Backboard in Emergency Department
  3. Children more often affected
  • Risk Factors
  1. Children
  2. Infusion dose >3-4 mg/kg/hour
  3. Infusion duration >12-24 hours (esp. >48 hours)
  4. Risk may be increased in patients with underlying mitochondrial disorders or Muscle disorders
  • Pathophysiology
  1. Propofol infusion results in mitochondrial respiration arrest (similar to cyanide Poisoning)
  • Risk Factors
  1. Young patients
  2. Sepsis
  3. Concurrent pressor or Glucocorticoid administration
  • Signs
  1. Metabolic Acidosis
  2. Lactic Acidosis
  3. Rhabdomyolysis
  4. Acute Kidney Injury
  5. Cardiac Failure
  6. Dysrhythmias
    1. Bradycardia
    2. Ventricular Tachycardia
    3. Asystole
  • Management
  1. Supportive care
  2. Carbohydrate substitution Dialysis and ECMO have been used
  3. Hemodialysis if Acute Renal Failure occurs
  • Prognosis
  1. High mortality rate
  • References
  1. Herbert (2012) EM:RAP 12(1): 3
  2. Claudius in Herbert (2019) EM:Rap 19(4): 12