Propofol infusion syndrome in children

@article{Bray1998PropofolIS,
  title={Propofol infusion syndrome in children},
  author={Bray},
  journal={Pediatric Anesthesia},
  year={1998},
  volume={8}
}
  • Bray
  • Published 1 November 1998
  • Medicine
  • Pediatric Anesthesia
Department of Anaesthesia, Royal Victoria Infirmary, Queen Victoria Road, Newcastle upon Tyne NE1 4LP, UKThe use of propofol infusions to sedate children in intensive care units has decreased after reports of deaths from myocardial failure. More recently it has been suggested that propofol might have been prematurely condemned. Information about 18 children who had received propofol infusions and suffered serious unwanted effects was used to define their common features. Three of the deaths… 

The use of propofol sedation in a paediatric intensive care unit.

Propofol infusion was used in this population at low risk of PRIS with no metabolic or circulatory adverse effects and the occurrence of adverse effects may not be directly related to dose or duration of infusion, but the risk that sporadic factors may be involved is emphasized.

Propofol infusion syndrome in anaesthesia and intensive care medicine

Dose limitations must be adhered to, and early warning signs such as lactacidosis should lead to the immediate cessation of propofol infusion, and new identified gene defects mimicking prop ofol infusion syndrome may elicit the underlying genetic susceptibility.

Propofol infusion syndrome

The clinical features of propofol infusion syndrome are acute refractory bradycardia leading to asystole, in the presence of one of the following: metabolic acidosis, rhabdomyolysis, hyperlipidaemia, and enlarged or fatty liver.

Continuous propofol infusion in 142 critically ill children.

Propofol can be safely and effectively used to provide sedation to critically ill infants and children and it is speculated that continuous infusion of propofol for extended periods of time should not exceed 67 microg/kg/min.

Propofol infusion syndrome: a case of increasing morbidity with traumatic brain injury.

A previously healthy 16-year-old boy with a closed, severe traumatic brain injury was admitted to a surgical and trauma intensive care unit and died of refractory cardiac dysrhythmia and circulatory collapse approximately 36 hours after the first signs of propofol infusion syndrome appeared.

Low-Dose Propofol Related Infusion Syndrome

Clinical should be aware of this syndrome in adults with prolonged infusion of low-dose propofol and combined catecholamines with severe metabolic acidosis, rhabdomyolysis, myoglobinuria, hyperkalemia, lipemia, renal failure, hepatomegaly, cardiac arrhythmias, and myocardial failure.

Propofol Infusion Syndrome in Critically Ill Patients

  • Tep M Kang
  • Medicine, Psychology
    The Annals of pharmacotherapy
  • 2002
Until further safety data become available, caution should be exercised when using high-dose (>5 mg/kg/h) and long-term (>48 h) propofol infusion in sedating critically ill adults.

Propofol Infusion Syndrome: Efficacy of a Prospective Screening Protocol

Serial CPK evaluations provided an effective screening tool and serum lactate can be dropped from screening and the screening protocol was effective in eliminating PIS.
...

References

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Although the exact cause of death in these children could not be defined, propofol may have been a contributing factor.

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It is suggested that propofol should not be used for prolonged sedation in children until its safety can be ensured.
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