Keyword
Propofol infusion syndrome
Definition
Propofol infusion syndrome is a rare but lethal syndrome associated with infusion of propofol at 4 mg/kg/hr or more for 48 hours or longer.
Signs & Symptoms
The clinical features of propofol infusion syndrome are acute refractory bradycardia leading to asystole, in the presence of one or more of the following:
metabolic acidosis (base deficit >10 mmol/L-1)
rhabdomyolysis
hyperlipidemia
enlarged or fatty liver
- Other features include cardiomyopathy with acute cardiac failure, skeletal myopathy, hyperkalemia, hepatomegaly, and lipemia
Pathophysiology
Theories about its causality include mitochondrial toxicity, mitochondrial defects, impaired tissue oxygenation, and carbohydrate deficiency.
The major risk factors for its development seem to be :
poor oxygen delivery
sepsis
serious cerebral injury
high propofol dosage
Reference
Miller’s Anesthesia, 7th edition, chapter 26.