Propofol infusion syndrome in children

  title={Propofol infusion syndrome in children},
  journal={Pediatric Anesthesia},
  • 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.

Propofol Infusion Is a Feasible Bridge to Extubation in General Pediatric Intensive Care Unit

In critically ill, mechanically ventilated patients, propofol infusion used over a short duration (<12 h) was found to be a feasible bridge to extubation.



Metabolic acidosis and fatal myocardial failure after propofol infusion in children: five case reports.

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

A comparison of propofol and other sedative use in paediatric intensive care in the United Kingdom

The findings of the survey suggest that propofol compares favourably with other sedative agents when used for sedating children in a paediatric intensive care unit.

Fatal myocardial failure associated with a propofol infusion in a child

The patient had two additional risk factors making seizures more likely in association with a high serum concentration of bupivacaine: although she had no previous history of convulsions she had a temperature of 38.5"C and was within the age group of children vulnerable for febrile Convulsions; hypoposphataemia may also cause cerebral irritability and convulsion.

Induction characteristics of propofol in children: comparison with thiopentone

It is concluded that the use of propofol is safe in children and may have advantages where early recovery from anaesthesia is desirable, but offers no advantage over thiopentone for routine induction of anaesthesia.

Propofol for induction of anaesthesia in children

Propofol induction produced significantly greater decreases in blood pressure, particularly in the 1–5‐year age group, and pain on injection into a vein on the dorsum of the hand was significantly more common with propofol despite the addition of lignocaine.

Comparison between propofol and thiopentone for induction of anaesthesia in children

It is concluded that propofol is a useful alternative as an induction agent in children's anaesthesia with a rapid and smooth induction with a low incidence of side effects.

Haemodynamic effects of propofol in children

The haemodynamic disturbance after induction of anaesthesia with propofol in children is not dose related, and noninvasive measurement of blood pressure showed that mean arterial pressure was reduced by approximately 15% after 1 minute, and by 30% after 5 minutes.

Comparison of cardiovascular changes during anaesthesia and recovery from propofol‐alfentanil‐nitrous oxide and thiopentone‐halothane‐nitrous oxide anaesthesia in children undergoing otolaryngological surgery

  • A. Hiller
  • Medicine
    Acta anaesthesiologica Scandinavica
  • 1993
Thiopentone/halothane anaesthesia is recommended for children aged 1–3 years and propofol/alfentanil anaesthesia for older children undergoing adenoidectomy and/or tonsillectomy.

Metabolic, biochemical and haemodynamic effects of infusion of propofol for long-term sedation of children undergoing intensive care.

In this small sample of children, prop ofol combined with fentanyl provided excellent sedation with no evidence of cardiac, renal or hepatic impairment, and propofol may be a safe sedative agent for use in paediatric intensive care if used appropriately.

Rhabdomyolysis and hypoxia associated with prolonged propofol infusion in children

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