Thursday, December 02, 2010

Propofol infusion syndrome

The propofol infusion syndrome was discussed at Nephron Power along with some links. I found helpful reviews here, here, here and here.

Because the syndrome has a high mortality even after appropriate treatment is initiated, early recognition should be helpful. Early red flags include escalating pressor requirements (a situation which might be easily overlooked since propofol infusion syndrome often develops in patients who are critically ill and already have fluctuating pressor requirements), hypertriglyceridemia and elevated CK. Two of the reviews mentioned the occasional development of new ECG abnormalities resembling the Brugada pattern.

Management consists of stopping propofol and general supportive care. There's nothing very specific about the supportive care except a suggestion that carbohydrate deprivation should be avoided, since patients with propofol infusion syndrome seem to have a problem with beta oxidation of fatty acids.

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