Unusual case of propofol-related infusion syndrome complicating severe COVID-19 ARDS.
BMJ Case Rep
; 16(2)2023 Feb 07.
Article
in English
| MEDLINE | ID: covidwho-2227800
ABSTRACT
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.
Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Respiratory Distress Syndrome
/
Acidosis
/
Hypertriglyceridemia
/
Propofol
/
Propofol Infusion Syndrome
/
COVID-19
/
Hyperlipidemias
Type of study:
Case report
Limits:
Aged
/
Humans
/
Male
Language:
English
Year:
2023
Document Type:
Article
Affiliation country:
Bcr-2022-249456
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