title: Propofol infusion syndrome: a retrospective analysis at a level 1 trauma center.
abstract: Objectives. The propofol infusion syndrome (PRIS), a rare, often fatal, condition of unknown etiology, is defined by development of lipemic serum, metabolic acidosis, rhabdomyolysis, hepatomegaly, cardiac arrhythmias, and acute renal failure. Methods. To identify risk factors for and biomarkers of PRIS, a retrospective chart review of all possible PRIS cases during a 1-year period was conducted at a level 1 trauma hospital in ICU patients over 18 years of age receiving continuous propofol infusions for ≥3 days. Additional study inclusion criteria included vasopressor support and monitoring of serum triglycerides and creatinine. Results. Seventy-two patients, 61 males (84.7%) and 11 females (15.3%), satisfied study inclusion criteria; and of these, 3 males met the study definition for PRIS, with 1 case fatality. PRIS incidence was 4.1% with a case-fatality rate of 33%. The mean duration of propofol infusion was 6.96 days. A positive linear correlation was observed between increasing triglyceride levels and infusion duration, but no correlation was observed between increasing creatinine levels and infusion duration. Conclusions. Risk factors for PRIS were confirmed as high dose infusions over prolonged periods. Increasing triglyceride levels may serve as reliable biomarkers of impending PRIS, if confirmed in future investigations with larger sample sizes.
authors.affiliation: Critical Care Medicine, Department of Anesthesiology, Louisiana State University Health Science Center, New Orleans, LA 70112, USA ; Environmental and Occupational Health Sciences, School of Public Health, Louisiana State University Health Science Center, New Orleans, LA 70112, USA.
authors.forename: James H
authors.initials: JH
authors.lastname: Diaz
authors.affiliation: Department of Anesthesiology, Louisiana State University Health Science Center, New Orleans, LA 70112, USA.
authors.forename: Amit
authors.initials: A
authors.lastname: Prabhakar
authors.affiliation: Department of Anesthesiology, Perioperative and Pain Medicine, Harvard Medical School, Brigham and Women's Hospital, Boston, MA 02115, USA.
authors.forename: Richard D
authors.initials: RD
authors.lastname: Urman
authors.affiliation: Department of Anesthesiology, Louisiana State University Health Science Center, New Orleans, LA 70112, USA ; Department of Pharmacology, Louisiana State University Health Science Center, New Orleans, LA 70112, USA.
authors.forename: Alan David
authors.initials: AD
authors.lastname: Kaye