Propofol Infusion Syndrome Heralded by ECG Changes

Mijzen, Elsbeth J.; Jacobs, Bram; Aslan, Adnan; Rodgers, Michael G. G.

doi:10.1007/s12028-012-9743-8

Cited by 17 publications

(3 citation statements)

References 21 publications

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“…This disorder is usually triggered by propofol infusion faster than 5 mg/kg/h for more than 48 h. It is characterized by LA, heart failure and a disturbance in mitochondrial long chain fatty acid oxidation induced multiorgan failure and rhabdomyolysis 6–9 . Mijzen et al 12 suggested that under normal conditions, reversal of T-waves on the electrocarodiogram (ECG) may be an early warning sign of PRIS. Despite there is no evidence whether our patients presented with PRIS, anesthesiologists should pay attention to the emulsive property of propofol.…”

Section: Discussionmentioning

confidence: 99%

Temporary hyperlactataemia during partial hepatectomy: Report of two cases

Zou

Ji-tong

Liao

et al. 2015

International Journal of Surgery Case Reports

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Lactic acidosis (LA) is characterized by accumulation of lactate in the body, and it may detrimentally affect homeostasis. Perioperative LA is rarely seen, here we presented 2 cases of patients suffered with temporary hyperlactataemia during partial hepatectomy, intended to emphasize that prolonged hypovolemia condition caused by controlled low central venous pressure, and overused hepatic vascular occlusion technique during parenchymal resection of hepatic surgery may seriously impact on the internal environment of patients. And we also discussed how to well manage long-time hepatectomy to prevent LA from occurring and to treat it appropriately.

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Section: Discussionmentioning

confidence: 99%

Temporary hyperlactataemia during partial hepatectomy: Report of two cases

Zou

Ji-tong

Liao

et al. 2015

International Journal of Surgery Case Reports

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“…Indeed, several case studies accentuated the early clinical manifestations of lactic acidosis following propofol infusion, supporting the previously mentioned theories of PRIS-related mitochondrial dysfunction [ 28 , 32 , 34 , 53 , 61 , 68 ]. Thereafter, symptoms of cardiac dysfunction start to materialize, often evidenced by ECG abnormalities such as tachycardia and T-wave inversions [ 62 , 70 , 83 ]. Several studies have also found ECG changes of Brugada-type ST elevations to be associated with imminent fatality [ 94 , 103 ].…”

Section: Reviewmentioning

confidence: 99%

Propofol-Related Infusion Syndrome: A Bibliometric Analysis of the 100 Most-Cited Articles

Van,

Lam,

Patel

et al. 2023

Cureus

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Propofol-related infusion syndrome (PRIS) is a rare, yet life-threatening sequelae to prolonged administration of the anesthetic propofol in mechanically intubated patients. The condition is characterized by progressive multi-system organ failure and eventual mortality; of note, the predominant characteristics of PRIS involve but are not limited to cardiovascular impairment and collapse, metabolic and lactic acidosis, rhabdomyolysis, hyperkalemia, and acute renal failure. While potent or extended doses of propofol have been found to be the primary precipitating factor of this condition, others such as age, critical illness, steroid therapy, and hyperlipidemia have been discovered to play a role as well. This bibliometric analysis was done to reflect the current relevance and understanding of PRIS in recent literature. The SCOPUS database was utilized to conduct a search for articles with keywords “propofol infusion syndrome” and “propofol syndrome” from February 24, 2001, until April 16, 2023, with parameters for article title, citation number, citation per year, author, institution, publishing journal, and country of origin. PRIS was first defined in 1990, just a year after its approval by the Food and Drug Administration for use as a sedative-hypnotic. Since then, interest in PRIS slowly rose up to 13 publications per year in 2013. Seven papers on the topic were published in Critical Care Medicine, six in Neurocritical Care , and four in Anesthesia . The most common institutions were Mayo Clinic, Northeastern University, and Tufts Medical Center. To our knowledge, this is the first bibliometric analysis to evaluate the most influential publications about PRIS. A majority of the research is case-based, possibly owing to the rarity of the condition. Our research suggests that confounding factors outside the precipitating dosage of propofol may be implicated in the onset and progression of PRIS. This study could therefore bring renewed interest to the topic and lead to additional research focused on fully understanding the pathophysiology of PRIS in order to promote the development of novel diagnostics and treatment.

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“…This syndrome, PRIS, is estimated to occur in about 1% of patients receiving propofol infusion, but it can be irreversible once identified, with 18-30% mortality among those affected [62]. Other symptoms include rhabdomyolysis [63,64], elevated cardiac enzymes, inverted T wave [65], hyperkalemia [66], elevated serum acylcarnitines [67], and Brugada-like electrocardiographic pattern (ST segment elevation in the precordial leads) [68]. Risk factors include pediatric age; concurrent vasopressor therapy; higher Acute Physiology, Age, Chronic Health Evaluation (APACHE) score (in adults); and neurologic injury including seizure and traumatic brain injury [63,69].…”

Section: Propofol-related Infusion Syndrome (Pris)mentioning

confidence: 99%