PMID- 36750301
OWN - NLM
STAT- MEDLINE
DCOM- 20230209
LR  - 20230209
IS  - 1757-790X (Electronic)
IS  - 1757-790X (Linking)
VI  - 16
IP  - 2
DP  - 2023 Feb 7
TI  - Unusual case of propofol-related infusion syndrome complicating severe COVID-19 
      ARDS.
LID - 10.1136/bcr-2022-249456 [doi]
LID - e249456
AB  - 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.
CI  - (c) BMJ Publishing Group Limited 2023. No commercial re-use. See rights and 
      permissions. Published by BMJ.
FAU - Babu, Vedesh Kumar
AU  - Babu VK
AD  - Internal Medicine Residency, Texas Tech University Health Sciences Center School 
      of Medicine, Odessa, Texas, USA vebabu@ttuhsc.edu.
FAU - Rojas, Pedro
AU  - Rojas P
AD  - Internal Medicine Residency, Texas Tech University Health Sciences Center School 
      of Medicine, Odessa, Texas, USA.
FAU - Perez Del Nogal, Genesis
AU  - Perez Del Nogal G
AD  - Internal Medicine Residency, Texas Tech University Health Sciences Center School 
      of Medicine, Odessa, Texas, USA.
FAU - Garcia-Fernandez, Alejandra
AU  - Garcia-Fernandez A
AD  - Internal Medicine Residency, Texas Tech University Health Sciences Center School 
      of Medicine, Odessa, Texas, USA.
LA  - eng
PT  - Case Reports
PT  - Journal Article
DEP - 20230207
PL  - England
TA  - BMJ Case Rep
JT  - BMJ case reports
JID - 101526291
RN  - YI7VU623SF (Propofol)
SB  - IM
MH  - Male
MH  - Humans
MH  - Aged
MH  - *Propofol
MH  - *Propofol Infusion Syndrome
MH  - *COVID-19
MH  - *Hyperlipidemias
MH  - *Hypertriglyceridemia
MH  - *Acidosis
MH  - *Respiratory Distress Syndrome
PMC - PMC9906275
OTO - NOTNLM
OT  - Acute renal failure
OT  - Adult intensive care
OT  - COVID-19
OT  - Drugs and medicines
OT  - Unwanted effects / adverse reactions
COIS- Competing interests: None declared.
EDAT- 2023/02/08 06:00
MHDA- 2023/02/10 06:00
PMCR- 2023/02/07
CRDT- 2023/02/07 21:02
PHST- 2023/02/07 21:02 [entrez]
PHST- 2023/02/08 06:00 [pubmed]
PHST- 2023/02/10 06:00 [medline]
PHST- 2023/02/07 00:00 [pmc-release]
AID - 16/2/e249456 [pii]
AID - bcr-2022-249456 [pii]
AID - 10.1136/bcr-2022-249456 [doi]
PST - epublish
SO  - BMJ Case Rep. 2023 Feb 7;16(2):e249456. doi: 10.1136/bcr-2022-249456.