Propofol Related Infusion Syndrome (PRIS)

  • cardiac failure, arrhythmias

  • rhabdomyolysis

  • metabolic acidosis, unexplained lactic acidosis

  • kidney failure

  • often fatal

  • hyperkalemia

  • high triglycerides

  • hepatomegaly

  • green urine (some sources say there is no correlation with PRIS)

  • proposed to be caused by either "a direct mitochondrial respiratory chain inhibition or impaired mitochondrial fatty acid metabolism"

  • more commonly in children, and critically ill patients receiving catecholamines and glucocorticoids are at high risk

  • Treatment

    • supportive

    • pacing

    • adequate carbohydrate intake (6-8mg/kg/min)

    • carnitine supplementation (theoretical benefit)

... but I would more especially commend the clinician who, in acute diseases, by which the bulk of mankind are cutoff, conducts the treatment better than others.
 
Hippocrates, 400 BC