Rare, potentially fatal, poorly understood propofol infusion syndrome

Autor: Eva Annen, Thierry Girard, Albert Urwyler
Jazyk: angličtina
Rok vydání: 2012
Předmět:
Zdroj: Clinics and Practice, Vol 2, Iss 3 (2012)
Druh dokumentu: article
ISSN: 2039-7275
2039-7283
DOI: 10.4081/cp.2012.e79
Popis: We present the case of a 7-year old boy with traumatic brain injury who received propofol during 38 h. Thirty-six hours after cessation of propofol infusion asystole occurred. After immediate mechanical and medical resuscitation, unreactive dilated pupils were observed. The following computed tomography scan revealed a generalized brain edema with transtentorial herniation. Prolonged bradyarrhythmia, rhabdomyolysis, and peracute renal failure were observed. Despite immediate craniectomy, barbiturate treatment, hemofiltration, and recovery of appropriate cardiac function, the patient died four days after discontinuation of propofol. In this case, metabolic acidosis, cardiac failure, rhabdomyolysis, and renal failure are in accordance with the symptoms of propofol infusion syndrome (PRIS), while seizure, brain edema, and transtentorial herniation could be caused by traumatic brain injury. However, it may be assumed that the entire clinical picture was caused by PRIS. This view could be explained by a common loss of function of ryanodine receptors in patients presenting with PRIS.
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