Propofol Infusion Syndrome

Rare and often fatal drug complication which affects patients undergoing long-term treatment with high doses of PROPOFOL. It is characterized by METABOLIC ACIDOSIS; HYPERLIPIDEMIA; RHABDOMYOLYSIS; cardiovascular CIRCULATORY COLLAPSE; CARDIAC FAILURE; and KIDNEY FAILURE.

Also Known As:

Networked: 150 relevant articles (1 outcomes, 1 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1.	Rhabdomyolysis
2.	Acidosis
3.	Critical Illness (Critically Ill)
4.	Heart Failure
5.	Status Epilepticus (Complex Partial Status Epilepticus)

Experts

1.	Duška, František: 3 articles (01/2019 - 11/2015)
2.	Krajčová, Adéla: 3 articles (01/2019 - 11/2015)
3.	Waldauf, Petr: 3 articles (01/2019 - 11/2015)
4.	Cremer, Olaf L: 3 articles (01/2009 - 02/2006)
5.	Ozaki, Makoto: 2 articles (01/2020 - 10/2005)
6.	Urban, Tomáš: 2 articles (01/2019 - 01/2018)
7.	Anděl, Michal: 2 articles (01/2018 - 11/2015)
8.	Wappler, Frank: 2 articles (10/2017 - 07/2006)
9.	Finsterer, Josef: 2 articles (11/2016 - 04/2010)
10.	Bein, B: 2 articles (06/2013 - 05/2009)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Propofol Infusion Syndrome:

1.	CarbohydratesIBA 08/01/2006 - "Reported cases of similar syndromes may represent initial propofol infusion syndrome, and may help to identify further risk factors such as low carbohydrate supply and early warning signs such as lactacidosis. " 01/01/2015 - "Certain risk factors for the development of propofol infusion syndrome are described, such as appropriate propofol doses and durations of administration, carbohydrate depletion, severe illness, and concomitant administration of catecholamines and glucocorticosteroids. "
2.	Biomarkers (Surrogate Marker)IBA 12/01/2013 - "Biochemical markers in total intravenous anesthesia and propofol infusion syndrome: a preliminary study."
3.	Propofol (Diprivan)FDA LinkGeneric 07/01/2023 - "However, the administration of propofol in children undergoing prolonged procedures, especially those younger than six months, should be carefully controlled due to the potential risk of propofol infusion syndrome. " 06/01/2023 - "This review concisely summarizes the dual arrhythmic cardiovascular effects of propofol and a rare but serious complication, propofol infusion syndrome (PRIS). " 02/07/2023 - "Suspecting propofol-related infusion syndrome (PRIS), we discontinued his propofol infusion immediately and initiated supportive measures. " 11/01/2022 - "Propofol infusion syndrome (PRIS) is a multifactorial condition that, upon propofol administration, can interrupt critical cellular processes. " 11/01/2022 - "Propofol infusion syndrome (PRIS) is a potentially lethal consequence of long-term propofol administration. "
4.	Anesthetics (Anesthetic Agents)IBA 07/01/2012 - "These anesthetic courses were uneventful without symptoms of malignant hyperthermia nor propofol infusion syndrome. " 05/01/2022 - "It shows a lower incidence of cardiorespiratory depression, less injection pain, and no fatal complications such as propofol infusion syndrome and malignant hyperthermia of inhalational anesthetics. " 11/05/2023 - "Propofol, an anesthetic characterized by its benefits of rapid induction, maintenance, and recovery times, may cause cytotoxic effects, resulting in propofol infusion syndrome (PRIS). " 10/01/2023 - "Propofol-related infusion syndrome (PRIS) is a rare, yet life-threatening sequelae to prolonged administration of the anesthetic propofol in mechanically intubated patients. " 01/01/2010 - "Propofol is a safe anesthetic agent, but propofol infusion syndrome is a rare lethal complication."
5.	Hypnotics and Sedatives (Sedatives)IBA 01/01/2009 - "It remains unclear whether these reports reflect true propofol infusion syndrome detected at an earlier and more salvageable stage, or mere associations with the use of sedative agents in general. " 02/01/2008 - "Probably, the absence of maximum dose recommendations has originated the case's description of severe complications, sometimes mortal, or sedative toxicity, like propofol infusion syndrome. " 03/01/2020 - "Propofol infusion syndrome is a rare condition that mainly affects critically ill patients who receive high doses of this hypnotic for a long time. " 05/01/2012 - "The traditional GABAergic agents, including benzodiazepines and propofol, have some limitations for safe sedatives in this setting, due to an unfavorable pharmacokinetic profile and to detrimental adverse effects (such as lorazepam associated propylene glycol intoxication and propofol infusion syndrome). " 07/01/2009 - "New approaches to improving outcomes for intensive care unit (ICU) patients include providing analgesia before adding sedation and recognizing dangerous adverse effects associated with sedative medications, such as prolonged effects of midazolam, propylene glycol toxicity with lorazepam, propofol infusion syndrome, the deliriogenic effects of benzodiazepines and propofol, and bradycardia with dexmedetomidine. "
6.	DexmedetomidineFDA Link 01/01/2021 - "Dexmedetomidine may be employed to facilitate serial NWTs, and should always be used in the non-intubated patient or if propofol infusion syndrome (PRIS) develops. " 08/01/2005 - "Propofol has gained great favor in the adult population as a means of providing deep sedation while allowing for rapid awakening; however, its routine use is not recommended because of its potential association with "propofol infusion syndrome." As the pediatric experience increases, it appears that there will be a role for newer agents such as dexmedetomidine." 05/01/2005 - "This review focuses on many issues, including the potentially fatal consequences associated with the propofol infusion syndrome, the evolving understanding of propylene glycol intoxication associated with parenteral lorazepam, new data involving high-dose and long-term dexmedetomidine therapy, haloperidol- and methadone-related prolongation of QTc intervals on the electrocardiogram, adverse events associated with atypical antipsychotics, and the potential for nonsteroidal antiinflammatory drugs to interfere with bone healing." 07/01/2009 - "New approaches to improving outcomes for intensive care unit (ICU) patients include providing analgesia before adding sedation and recognizing dangerous adverse effects associated with sedative medications, such as prolonged effects of midazolam, propylene glycol toxicity with lorazepam, propofol infusion syndrome, the deliriogenic effects of benzodiazepines and propofol, and bradycardia with dexmedetomidine. "
7.	CatecholaminesIBA 09/01/2006 - "The use of catecholamine infusions to maintain cerebral perfusion pressure in the setting of a high-dose propofol infusion may be pharmacologically unsound and may be a triggering factor for propofol infusion syndrome. " 01/01/2015 - "Certain risk factors for the development of propofol infusion syndrome are described, such as appropriate propofol doses and durations of administration, carbohydrate depletion, severe illness, and concomitant administration of catecholamines and glucocorticosteroids. " 09/01/2003 - "Propofol infusion syndrome is multifactorial, and propofol, particularly when combined with catecholamines and/or steroids, acts as a triggering factor. " 10/01/2006 - "Several adult patients, all with acute neurological disorders, have been reported suffering from propofol infusion syndrome, which occurs in patients receiving high-dose propofol and catecholamines and/or steroids. "
8.	BenzodiazepinesIBA 08/01/2022 - "A beneficial use of propofol is to facilitate weaning of other pain and sedation infusions such as opiates and benzodiazepines. However, some have advocated to not use propofol due to fear of possible adverse effects including propofol infusion syndrome and hemodynamic instability. " 05/01/2007 - "Propofol infusion for the treatment of status epilepticus should be carefully weighted against its real risk to develop propofol infusion syndrome, and alternative agents such as benzodiazepines or barbiturates should be considered for first line therapy. " 05/01/2012 - "The traditional GABAergic agents, including benzodiazepines and propofol, have some limitations for safe sedatives in this setting, due to an unfavorable pharmacokinetic profile and to detrimental adverse effects (such as lorazepam associated propylene glycol intoxication and propofol infusion syndrome). " 07/01/2009 - "New approaches to improving outcomes for intensive care unit (ICU) patients include providing analgesia before adding sedation and recognizing dangerous adverse effects associated with sedative medications, such as prolonged effects of midazolam, propylene glycol toxicity with lorazepam, propofol infusion syndrome, the deliriogenic effects of benzodiazepines and propofol, and bradycardia with dexmedetomidine. "
9.	Propylene Glycol (1,2 Propanediol)FDA LinkGeneric 05/01/2012 - "The traditional GABAergic agents, including benzodiazepines and propofol, have some limitations for safe sedatives in this setting, due to an unfavorable pharmacokinetic profile and to detrimental adverse effects (such as lorazepam associated propylene glycol intoxication and propofol infusion syndrome). " 05/01/2005 - "This review focuses on many issues, including the potentially fatal consequences associated with the propofol infusion syndrome, the evolving understanding of propylene glycol intoxication associated with parenteral lorazepam, new data involving high-dose and long-term dexmedetomidine therapy, haloperidol- and methadone-related prolongation of QTc intervals on the electrocardiogram, adverse events associated with atypical antipsychotics, and the potential for nonsteroidal antiinflammatory drugs to interfere with bone healing." 07/01/2009 - "New approaches to improving outcomes for intensive care unit (ICU) patients include providing analgesia before adding sedation and recognizing dangerous adverse effects associated with sedative medications, such as prolonged effects of midazolam, propylene glycol toxicity with lorazepam, propofol infusion syndrome, the deliriogenic effects of benzodiazepines and propofol, and bradycardia with dexmedetomidine. "
10.	SteroidsIBA 09/01/2003 - "Propofol infusion syndrome is multifactorial, and propofol, particularly when combined with catecholamines and/or steroids, acts as a triggering factor. " 10/01/2006 - "Several adult patients, all with acute neurological disorders, have been reported suffering from propofol infusion syndrome, which occurs in patients receiving high-dose propofol and catecholamines and/or steroids. " 04/01/2010 - "Typical side effects may be steroid myopathy, propofol syndrome, statin/fibrate myopathy, neuroleptic-induced extrapyramidal signs, or zidovudine myopathy. "

Therapies and Procedures

1.	Intravenous Anesthesia 01/01/2016 - "Although several severe perioperative complications and deaths have been reported, malignant hyperthermia had not been reported in adult cases, and metabolic disorder called propofol infusion syndrome had also not been reported in adult patients undergone total intravenous anesthesia. " 12/01/2013 - "Biochemical markers in total intravenous anesthesia and propofol infusion syndrome: a preliminary study." 12/01/2013 - "To investigate biochemically whether total intravenous anesthesia (TIVA) using propofol creates a risk for Propofol Infusion Syndrome (PRIS). "
2.	Therapeutics 10/01/2023 - "We present a case of a 3-year-old female with RSE who developed propofol-related infusion syndrome (PRIS) despite low dosage after failed attempts with multiple anti-epileptic drips and bolus therapies. " 01/01/2023 - "VA-ECMO rescue therapy in propofol infusion syndrome after cardiac surgery." 01/01/2019 - "Minor outcomes included the change in TG concentration from therapy initiation and manifestations of propofol-related infusion syndrome (PRIS). " 01/01/2021 - "We report a unilateral PRES patient characterized by a gradual onset followed by propofol infusion syndrome (PRIS) due to general anesthesia therapy. " 11/01/2006 - "The cardinal signs and symptoms of the propofol infusion syndrome are metabolic acidosis, rhabdomyolysis, renal failure, cardiac arrhythmias and a progressive, often therapy-resistant cardiac failure. "
3.	Anesthesia 06/01/2017 - "Special considerations and concerns, such as risk for propofol infusion syndrome and adverse potential side effects of anesthesia agents, are discussed. " 02/01/2010 - "Anesthesia in pediatric patients may be different than in adults due to the specific anesthesia considerations in children, notably the propofol infusion syndrome (PRIS) and the need to monitor immature neural pathways. " 06/01/2005 - "Propofol infusion syndrome associated with short-term large-dose infusion during surgical anesthesia in an adult." 08/01/2022 - "In the present case, anesthesia was maintained with inhalation anesthetics to avoid the development of propofol infusion syndrome. " 10/01/2004 - "Propofol infusion syndrome has not only been observed in patients undergoing long-term sedation with propofol, but also during propofol anesthesia lasting 5 h. "
4.	Critical Care (Surgical Intensive Care) 02/01/2008 - "Propofol-related infusion syndrome in intensive care patients." 08/01/2006 - "Propofol infusion syndrome in anaesthesia and intensive care medicine." 10/01/2003 - "Evaluation of propofol infusion syndrome in pediatric intensive care." 01/01/2013 - "Propofol-related infusion syndrome: role of propofol in medical complications of sedated critical care patients." 05/01/2012 - "Propofol is not licensed for sedation in pediatric intensive care medicine mainly due to the risk of propofol infusion syndrome. "
5.	Extracorporeal Membrane Oxygenation 08/01/2020 - "Consider Heightened Awareness of Propofol Infusion Syndrome after Extracorporeal Membrane Oxygenation (ECMO) Decannulation." 09/23/2013 - "Propofol infusion syndrome resuscitation with extracorporeal life support: a case report and review of the literature." 11/01/2015 - "Extracorporeal membrane oxygenation and sustained low-efficiency diafiltration successfully resuscitated propofol infusion syndrome during refractory status epilepticus." 10/01/2023 - "Propofol-Related Infusion Syndrome in a Child With Refractory Status Epilepticus: Successful Resuscitation With Veno-Arterial Extracorporeal Membrane Oxygenation, Continuous Renal Replacement Therapy, and Therapeutic Plasma Exchange." 01/01/2015 - "Management of overt propofol infusion syndrome requires immediate discontinuation of propofol infusion and supportive management, including hemodialysis, hemodynamic support, and extracorporeal membrane oxygenation in refractory cases. "