TYK201
Which of the following are NOT associated with propofol infusion syndrome (PRIS)?
A. Non-gap metabolic acidosis
B. Hypotension
C. Fatty liver enlargement
D. Rhabdomyolysis
E. Myoglobinuria
F. Bradycardia
Answer
The answer is A. It is an INCREASED gap (lactic) acidosis. Propofol has been associated with several adverse effects in children and adults undergoing prolonged infusions (greater than 48 hours) at high doses of greater that 4 mg/kg per hour. This propofol infusion syndrome (PRIS) is characterized by bradycardia, hypotension, lipemic plasma, fatty liver enlargement, significant lactic acidosis, rhabdomyolysis, and myoglobinuria. Usually, PRIS leads to fatal renal, cardiac, and circulatory failure.
PRIS is caused by propofol’s impairment of oxygen utilization and inhibition of mitochondrial electron transport, leading to cytolysis of both skeletal and cardiac muscle cells. Children appear to be more prone to PRIS because of low glycogen storage and high dependence on fat metabolism. Current therapy involves immediate stoppage of the propofol infusion, cardiorespiratory support, and hemodialysis or hemofiltration to eliminate the propofol and its toxic metabolites. Carbohydrate supplementation is also recommended. [1][2][3]
Notes
- ↑ Kam, P. C. A., and D. Cardone. "Propofol infusion syndrome." Anaesthesia 62.7 (2007): 690-701.[1]
- ↑ Fudickar, Axel, Berthold Bein, and Peter H. Tonner. "Propofol infusion syndrome in anaesthesia and intensive care medicine." Current Opinion in Anesthesiology 19.4 (2006): 404-410.[2]
- ↑ Fudickar, A., and B. Bein. "Propofol infusion syndrome: update of clinical manifestation and pathophysiology." Minerva anestesiologica 75.5 (2009): 339.[3]
Keywords
- Propofol