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Rhabdomyolysis and hypoxia associated with prolonged propofol infusion in children
1Department of Neurology, MetroHealth Medical Center, Cleveland, OH 44109, USA.
Insights
Propofol infusion for refractory status epilepticus in children may cause severe metabolic acidosis, hypoxia, and rhabdomyolysis. Prolonged use is not recommended until safety is confirmed.
Area of Science:
- Anesthesiology
- Pediatric Critical Care
Background:
- Propofol is a widely used anesthetic for sedation in intensive care units.
- Its rapid elimination makes it suitable for inducing and maintaining hypnosis in refractory status epilepticus.
Observation:
- Severe metabolic acidosis, progressive hypoxia, and rhabdomyolysis were observed in a child and an adolescent.
- These adverse events occurred during maintenance propofol infusion for refractory status epilepticus.
Findings:
- The reported cases suggest a potential association between prolonged propofol sedation and severe metabolic complications in pediatric patients.
- Rhabdomyolysis, metabolic acidosis, and hypoxia are critical adverse events that warrant further investigation.
Implications:
- Propofol use for prolonged sedation in children with refractory status epilepticus should be approached with caution.
- Further research is needed to ensure the safety of propofol in pediatric intensive care settings.
- Clinicians should be vigilant for signs of metabolic derangement and muscle injury during propofol therapy in children.
Abstract:
Propofol, a new anesthetic, is now used more commonly to sedate patients in the intensive care unit. Propofol's rapid elimination has popularized its use to induce and maintain hypnosis in patients with refractory status epilepticus. It is also associated with occasional severe metabolic acidosis and hypoxia of indeterminate cause in children. We report a child and an adolescent who developed severe metabolic acidosis, progressive hypoxia, and rhabdomyolysis during maintenance infusion of propofol for the treatment of refractory status epilepticus. We suggest that propofol should not be used for prolonged sedation in children until its safety can be ensured.