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Unusual case of propofol-related infusion syndrome complicating severe COVID-19 ARDS
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/h...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9906275/ https://www.ncbi.nlm.nih.gov/pubmed/36750301 http://dx.doi.org/10.1136/bcr-2022-249456 |
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author | Babu, Vedesh Kumar Rojas, Pedro Perez Del Nogal, Genesis Garcia-Fernandez, Alejandra |
author_facet | Babu, Vedesh Kumar Rojas, Pedro Perez Del Nogal, Genesis Garcia-Fernandez, Alejandra |
author_sort | Babu, Vedesh Kumar |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-9906275 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-99062752023-02-08 Unusual case of propofol-related infusion syndrome complicating severe COVID-19 ARDS Babu, Vedesh Kumar Rojas, Pedro Perez Del Nogal, Genesis Garcia-Fernandez, Alejandra BMJ Case Rep Case Reports: Adverse drug reactions and complications 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. BMJ Publishing Group 2023-02-07 /pmc/articles/PMC9906275/ /pubmed/36750301 http://dx.doi.org/10.1136/bcr-2022-249456 Text en © BMJ Publishing Group Limited 2023. No commercial re-use. See rights and permissions. Published by BMJ. |
spellingShingle | Case Reports: Adverse drug reactions and complications Babu, Vedesh Kumar Rojas, Pedro Perez Del Nogal, Genesis Garcia-Fernandez, Alejandra Unusual case of propofol-related infusion syndrome complicating severe COVID-19 ARDS |
title | Unusual case of propofol-related infusion syndrome complicating severe COVID-19 ARDS |
title_full | Unusual case of propofol-related infusion syndrome complicating severe COVID-19 ARDS |
title_fullStr | Unusual case of propofol-related infusion syndrome complicating severe COVID-19 ARDS |
title_full_unstemmed | Unusual case of propofol-related infusion syndrome complicating severe COVID-19 ARDS |
title_short | Unusual case of propofol-related infusion syndrome complicating severe COVID-19 ARDS |
title_sort | unusual case of propofol-related infusion syndrome complicating severe covid-19 ards |
topic | Case Reports: Adverse drug reactions and complications |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9906275/ https://www.ncbi.nlm.nih.gov/pubmed/36750301 http://dx.doi.org/10.1136/bcr-2022-249456 |
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