Propofol infusion syndrome
From IDWiki
Definition
- A life-threatening condition characterised by acute refractory bradycardia progressing to asystole with one or more of:
- Metabolic acidosis
- Rhabdomyolysis
- Hyperlipidaemia
- Enlarged or fatty liver
Pathophysiology
- Unknown
Risk Factors
- Propofol infusion >4mg/kg/h x48h
- Younger age
- Acute neurological injury
- Low carbohydrate intake
- Concurrent catecholamine infusion
- Concurrent corticosteroids infusion
Investigations
- Laboratory
- ABG showing metabolic acidosis
- Lactate, elevated without other cause
- Electrolytes, for hyperkalemia
- Creatinine and CK, for renal failure and rhabdomyolysis
- Other
- EKG, showing a Brugada pattern, RBBB, arrhythmia, or heart block
Management
- Stop propofol infusion
- Supportive care
