What is the pathophysiology of propofol infusion syndrome?

Likely to be a combination of mitochondrial respiratory chain inhibition and impaired mitochondrial fatty acid metabolism Combination predisposes to intracellular dysfunction and apoptosis In addition propofol is a direct myocardial depressant   Respiratory chain...

How does propofol infusion syndrome present?

Cardiac dysfunction (88%): Acute bradycardia leading to asystole Brugada-like ECG changes Arrhythmias & bundle branch blocks New-onset metabolic acidosis (86%): Lactic acidosis & renal failure (HAGMA) Renal abnormalities: Renal Failure (37%) Hyperkalaemia...

How do you work up the patient with suspected PRIS?

To Determine Diagnosis Laboratory Investigations Serum Triglycerides Creatinine Kinase Serum Propofol Levels U&Es LFTs Blood Gas Clinical Investigations ECG Urinalysis Elevated (>200 mg/dL) Elevated Elevated Renal failure Raised transaminases Unexplained lactic...

What is the management of propofol infusion syndrome?

Key PrinciplesPrompt removal of propofol infusionAggressive supportive careConsideration of haemodfiltration or plasma exchangeVA ECMO in refractory cases Initial Resuscitation & Supportive Care Management almost entirely supportiveStop the propofol and use...