Propofol
- PDF / 141,959 Bytes
- 1 Pages / 595.245 x 841.846 pts (A4) Page_size
- 42 Downloads / 152 Views
1
S
Propofol infusion syndrome: case report A 24-year-old man developed propofol infusion syndrome after receiving propofol for sedation and to maintain a low intracranial pressure following a craniotomy. The man received a propofol infusion at a rate of 3.0–5.8 mg/kg/hour for sedation and maintenance of a low intracranial pressure following a craniotomy for right intracranial haemorrhage. After an 84-hour infusion, he developed bradyarrhythmias, and propofol was discontinued. Despite administration of atropine and catecholamines, he had a persistent junctional rhythm of 45–55 beats/minute. Hypoxia and progressive neck vein distension developed. Echocardiogram revealed right heart pump failure and right-sided volume overload. Bradycardia progressed to cardiac arrest 3 hours after propofol was withdrawn, and resolved with cardiotonics and cardiac massage. Supraventricular tachycardia with ST elevation occurred, followed by ventricular tachycardia, which resolved following electric cardioversion. Laboratory findings revealed hyperkalaemia, metabolic acidosis, hepatic failure and marked muscle damage. His triglyceride levels were normal but his urine was dark brown. He was diagnosed with propofol infusion syndrome. The man received continuous venovenous haemofiltration. Neck vein distension, hypotension and hypoxia resolved in the following few hours, and cardiotonics were withdrawn. A second echocardiogram showed recovery of right ventricular contractility, and no volume overload. He recovered well and was discharged 3 months later, following a rehabilitation program for his left hemiparesis. He experienced no significant cardiovascular or pulmonary sequelae. Author comment: "The mechanism of [propofol infusion syndrome] is thought to be direct mitochondrial respiratory chain inhibition by propofol or its metabolites." Tseng Y-T, et al. Propofol Infusion Syndrome Leads to Severe Right Heart Injury and Lethal Arrhythmias. Journal of Experimental and Clinical Medicine 2: 192-195, No. 4, Aug 2010. Available from: URL: http://dx.doi.org/10.1016/ 803039148 s1878-3317%2810%2960030-7 - Taiwan
0114-9954/10/1320-0001/$14.95 © 2010 Adis Data Information BV. All rights reserved
Reactions 25 Sep 2010 No. 1320
Data Loading...
