Propofol Infusion Syndrome in Adults: A Clinical Update
Propofol infusion syndrome is a rare but extremely dangerous complication of propofol administration. 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...
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| Format: | Article |
| Language: | English |
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Wiley
2015-01-01
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| Series: | Critical Care Research and Practice |
| Online Access: | http://dx.doi.org/10.1155/2015/260385 |
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| author | Aibek E. Mirrakhimov Prakruthi Voore Oleksandr Halytskyy Maliha Khan Alaa M. Ali |
| author_facet | Aibek E. Mirrakhimov Prakruthi Voore Oleksandr Halytskyy Maliha Khan Alaa M. Ali |
| author_sort | Aibek E. Mirrakhimov |
| collection | DOAJ |
| description | Propofol infusion syndrome is a rare but extremely dangerous complication of propofol administration. 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 pathophysiology of this condition includes impairment of mitochondrial beta-oxidation of fatty acids, disruption of the electron transport chain, and blockage of beta-adrenoreceptors and cardiac calcium channels. The disease commonly presents as an otherwise unexplained high anion gap metabolic acidosis, rhabdomyolysis, hyperkalemia, acute kidney injury, elevated liver enzymes, and cardiac dysfunction. Management of overt propofol infusion syndrome requires immediate discontinuation of propofol infusion and supportive management, including hemodialysis, hemodynamic support, and extracorporeal membrane oxygenation in refractory cases. However, we must emphasize that given the high mortality of propofol infusion syndrome, the best management is prevention. Clinicians should consider alternative sedative regimes to prolonged propofol infusions and remain within recommended maximal dose limits. |
| format | Article |
| id | doaj-art-823e9e9ac23c4b7faf5c3461baa0318a |
| institution | Kabale University |
| issn | 2090-1305 2090-1313 |
| language | English |
| publishDate | 2015-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Critical Care Research and Practice |
| spelling | doaj-art-823e9e9ac23c4b7faf5c3461baa0318a2025-02-03T05:45:26ZengWileyCritical Care Research and Practice2090-13052090-13132015-01-01201510.1155/2015/260385260385Propofol Infusion Syndrome in Adults: A Clinical UpdateAibek E. Mirrakhimov0Prakruthi Voore1Oleksandr Halytskyy2Maliha Khan3Alaa M. Ali4Department of Internal Medicine, Saint Joseph Hospital, 2900 N. Lake Shore, Chicago, IL 60657, USADepartment of Internal Medicine, Saint Joseph Hospital, 2900 N. Lake Shore, Chicago, IL 60657, USADepartment of Internal Medicine, Saint Joseph Hospital, 2900 N. Lake Shore, Chicago, IL 60657, USADepartment of Internal Medicine, Saint Joseph Hospital, 2900 N. Lake Shore, Chicago, IL 60657, USADepartment of Internal Medicine, Saint Joseph Hospital, 2900 N. Lake Shore, Chicago, IL 60657, USAPropofol infusion syndrome is a rare but extremely dangerous complication of propofol administration. 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 pathophysiology of this condition includes impairment of mitochondrial beta-oxidation of fatty acids, disruption of the electron transport chain, and blockage of beta-adrenoreceptors and cardiac calcium channels. The disease commonly presents as an otherwise unexplained high anion gap metabolic acidosis, rhabdomyolysis, hyperkalemia, acute kidney injury, elevated liver enzymes, and cardiac dysfunction. Management of overt propofol infusion syndrome requires immediate discontinuation of propofol infusion and supportive management, including hemodialysis, hemodynamic support, and extracorporeal membrane oxygenation in refractory cases. However, we must emphasize that given the high mortality of propofol infusion syndrome, the best management is prevention. Clinicians should consider alternative sedative regimes to prolonged propofol infusions and remain within recommended maximal dose limits.http://dx.doi.org/10.1155/2015/260385 |
| spellingShingle | Aibek E. Mirrakhimov Prakruthi Voore Oleksandr Halytskyy Maliha Khan Alaa M. Ali Propofol Infusion Syndrome in Adults: A Clinical Update Critical Care Research and Practice |
| title | Propofol Infusion Syndrome in Adults: A Clinical Update |
| title_full | Propofol Infusion Syndrome in Adults: A Clinical Update |
| title_fullStr | Propofol Infusion Syndrome in Adults: A Clinical Update |
| title_full_unstemmed | Propofol Infusion Syndrome in Adults: A Clinical Update |
| title_short | Propofol Infusion Syndrome in Adults: A Clinical Update |
| title_sort | propofol infusion syndrome in adults a clinical update |
| url | http://dx.doi.org/10.1155/2015/260385 |
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