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A death associated with possible propofol infusion syndrome
Nikhil Agrawal1, Sudhakar Rao2, Roshan Nair3
1Trauma Fellow, State Trauma Unit, Royal Perth Hospital, Wellington Street, Perth, Western Australia.
The Indian Journal of Surgery
|January 16, 2014
Summary
Propofol infusions can cause Proprioception Related Infusion Syndrome (PRIS), a rare fatal condition. This case highlights severe metabolic acidosis and hyperkalemia in a polytrauma patient receiving continuous propofol, leading to a fatal outcome.
Area of Science:
- Anesthesiology
- Critical Care Medicine
- Pharmacology
Background:
- Propofol is a widely used anesthetic agent known for its rapid onset and short recovery.
- Prolonged infusions of propofol at high doses are associated with Proprioception Related Infusion Syndrome (PRIS).
- PRIS is a rare but potentially fatal complication characterized by metabolic disturbances.
Purpose of the Study:
- To report a case of severe metabolic acidosis and refractory hyperkalemia in a patient with polytrauma on continuous propofol infusion.
- To emphasize the risks associated with prolonged, high-dose propofol administration.
- To highlight the fatal outcome associated with PRIS in a critical care setting.
Main Methods:
- Case report of a 53-year-old female patient with polytrauma.
- Continuous propofol infusion administered for sedation.
- Monitoring of metabolic parameters, including acid-base balance and electrolytes.
Main Results:
- The patient developed severe metabolic acidosis and refractory hyperkalemia.
- These metabolic derangements were associated with the continuous propofol infusion.
- The patient experienced a fatal outcome, consistent with PRIS.
Conclusions:
- Continuous propofol infusions, particularly at high doses and prolonged durations, carry a risk of fatal PRIS.
- Close monitoring for metabolic complications is crucial in patients receiving long-term propofol infusions.
- This case underscores the importance of recognizing and managing PRIS to prevent adverse outcomes.
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