The pathophysiology of propofol infusion syndrome: a simple name for a complex syndrome

@article{Vasile2003ThePO,
  title={The pathophysiology of propofol infusion syndrome: a simple name for a complex syndrome},
  author={Beatrice Vasile and Frank A Rasulo and Andrea Candiani and Nicola Latronico},
  journal={Intensive Care Medicine},
  year={2003},
  volume={29},
  pages={1417-1425}
}
Propofol infusion syndrome (PRIS) is a rare and often fatal syndrome described in critically ill children undergoing long-term propofol infusion at high doses. Recently several cases have been reported in adults, too. The main features of the syndrome consist of cardiac failure, rhabdomyolysis, severe metabolic acidosis and renal failure. To date 21 paediatric cases and 14 adult cases have been described. These latter were mostly patients with acute neurological illnesses or acute inflammatory… 

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Lethal outcomes: propofol infusion syndrome and propofol abuse.
  • P. O'Malley
  • Medicine, Biology
    Clinical nurse specialist CNS
  • 2010
TLDR
The argument that PRIS represents a final common pathway for sepsis, renal failure, liver failure, inflammation, carbohydrate deprivation, or steroid and vasopressor use rather than propofol exposure does not explain why some patients have developed PRIS with only a brief exposure to prop ofol.
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TLDR
Clinicians should consider alternative sedative regimes to prolonged propofol infusions and remain within recommended maximal dose limits, given the high mortality of prop ofol infusion syndrome.
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TLDR
The article presents the main prophylactic measures to be taken when propofol is administered in large doses and for long periods of time, as well as proposals for management of PRIS.
Propofol infusion syndrome: an unusual cause of renal failure.
TLDR
The pathophysiology and the possible mechanisms of propofol infusion syndrome are examined and the need to consider it as the cause of rhabdomyolysis and acute renal failure in critically ill patients is illustrated.
Propofol infusion syndrome
TLDR
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.
[Propofol infusion syndrome].
Propofol-related infusion syndrome in critically ill pediatric patients: coincidence, association, or causation?
TLDR
The literature concerning PRIS, its clinical presentation, proposed mechanisms for the syndrome, and potential management should the syndrome occur are reviewed.
Update on the propofol infusion syndrome in ICU management of patients with head injury
TLDR
In patients with risk factors, such as traumatic brain injury, it is suggested that an infusion rate of 4 mg/kg per hour should not be exceeded, and early warning signs include unexplained lactic acidosis, lipemia and Brugada-like ECG changes.
Propofol infusion syndrome in anaesthesia and intensive care medicine
TLDR
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.
Sepsis and Propofol Related Infusion Syndrome in a 19-Year-Old Male Patient
  • Medicine
  • 2019
TLDR
A 19-year-old male involved in a motor vehicle collision was intubated and sedated with Propofol and developed PRIS and survived and was managed expectantly and ultimately discharged on hospital day 22.
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