What are the risk factors for developing propofol infusion syndrome?

Patient Related
  • Younger age:
    • Glycogen store is lower
    • Depend on fat metabolism
    • Committee on Safety of Medicine advised against use in children <16
  • Traumatic brain injury:
    • Likely higher catecholamines and higher agitation
      • Higher infusion rates required
    • Carnitine deficiency
    • Inborn errors of fatty acid metabolism
Therapy Related
  • High propofol infusion dose:
    • Association with dose of >4mg/kg/hr for over 48 hrs
      • Increased propofol clearance
      • Higher infusion rates required
    • Corticosteroid infusion
    • Low carbohydrate intake:
      • Energy demand is met by lipolysis
      • Leads to the accumulation of free fatty acids