Unusual case of propofol-related infusion syndrome complicating severe COVID-19 ARDS.

Autor:	Babu VK; Internal Medicine Residency, Texas Tech University Health Sciences Center School of Medicine, Odessa, Texas, USA vebabu@ttuhsc.edu., Rojas P; Internal Medicine Residency, Texas Tech University Health Sciences Center School of Medicine, Odessa, Texas, USA., Perez Del Nogal G; Internal Medicine Residency, Texas Tech University Health Sciences Center School of Medicine, Odessa, Texas, USA., Garcia-Fernandez A; Internal Medicine Residency, Texas Tech University Health Sciences Center School of Medicine, Odessa, Texas, USA.
Jazyk:	angličtina
Zdroj:	BMJ case reports [BMJ Case Rep] 2023 Feb 07; Vol. 16 (2). Date of Electronic Publication: 2023 Feb 07.
DOI:	10.1136/bcr-2022-249456
Abstrakt:	An elderly man presenting with shortness of breath and hypoxaemia was admitted with acute hypoxic respiratory failure secondary to COVID-19 pneumonia. Due to worsening hypoxaemia, he was transferred to the intensive care unit and required mechanical ventilation. Propofol was infused at 1.5-4 mg/kg/hour. Within 48 hours of initiation, we noticed worsening metabolic acidosis, acute kidney injury, hyperkalaemia, hyperphosphataemia, hypertriglyceridaemia, elevated creatine kinase and elevated myoglobin levels. Suspecting propofol-related infusion syndrome (PRIS), we discontinued his propofol infusion immediately and initiated supportive measures. In 48 hours, there was a significant improvement in metabolic acidosis, hypertriglyceridaemia, rhabdomyolysis and renal function. The propofol infusion rate and cumulative propofol dosage (under 140 mg/kg) were well below levels associated with PRIS. COVID-19's pathogenesis, still under investigation, may have contributed to this presentation. It is imperative for clinicians to maintain a high degree of suspicion once propofol is initiated, regardless of the cumulative dose or rate of infusion. Competing Interests: Competing interests: None declared. (© BMJ Publishing Group Limited 2023. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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