Propofol infusion syndrome

Area of Science:

• Intensive Care Medicine
• Forensic Pathology
• Toxicology

Background:

• Propofol is a widely used anesthetic agent.
• Propofol infusion syndrome (PRIS) is a rare but serious complication associated with high-dose infusions.
• PRIS is characterized by metabolic acidosis, rhabdomyolysis, myocardial failure, and renal impairment.

Purpose of the Study:

• To present a case of propofol infusion syndrome in a young adult following a head injury.
• To discuss the clinical and pathological findings consistent with PRIS.
• To emphasize the importance of PRIS for forensic pathologists.

Main Methods:

• Case report of a 31-year-old male patient admitted to ICU after a motor vehicle incident.
• Patient received high-dose propofol sedation for 8 days.
• Clinical monitoring, laboratory investigations, and a forensic autopsy were performed.

Main Results:

• The patient developed metabolic acidosis, rhabdomyolysis, renal impairment, and cardiovascular collapse.
• Autopsy revealed cardiac perivascular and interstitial mononuclear cell infiltrate.
• Clinical and pathological findings were consistent with propofol infusion syndrome.

Conclusions:

• Propofol infusion syndrome can be fatal and may occur in patients receiving high-dose propofol.
• Forensic pathologists should be aware of PRIS, especially in cases of unexplained patient deterioration in critical care.
• This case represents a death related to propofol infusion syndrome, not previously described in forensic literature.