title: Therapeutic plasma exchange as treatment for propofol infusion syndrome.
abstract: Propofol infusion syndrome (PRIS), a rare complication of propofol sedation, is associated with high mortality. There is no specific therapy. A 16-year-old with head injury and status epilepticus is described. Three days after seizure resolution, whilst receiving propofol, he developed severe lactic acidosis, rhabdomyolysis, and hemodynamic instability. Suspected PRIS was treated with a single session of therapeutic plasma exchange (TPE). This was associated with immediate improvement in hemodynamic status, resolution of lactic acidosis within 24 h, normalization of CPK over 10 days, and a subsequent full recovery. TPE is suggested as a novel therapy for PRIS.
authors.affiliation: Department of Anesthesiology and Critical Care Medicine, Hadassah Hebrew University Medical Center, Jerusalem, Israel.
authors.forename: Phillip D
authors.initials: PD
authors.lastname: Levin
authors.affiliation: Department of Anesthesiology and Critical Care Medicine, Hadassah Hebrew University Medical Center, Jerusalem, Israel.
authors.forename: Valentin
authors.initials: V
authors.lastname: Levin
authors.affiliation: Department of Anesthesiology and Critical Care Medicine, Hadassah Hebrew University Medical Center, Jerusalem, Israel.
authors.forename: Charles
authors.initials: C
authors.lastname: Weissman
authors.affiliation: Department of Anesthesiology and Critical Care Medicine, Hadassah Hebrew University Medical Center, Jerusalem, Israel.
authors.forename: Charles L
authors.initials: CL
authors.lastname: Sprung
authors.affiliation: Deparmtent of Hematology, Hadassah Hebrew University Medical Center, Jerusalem, Israel.
authors.forename: Deborah
authors.initials: D
authors.lastname: Rund
mesh_terms: D000063:Accidents, Traffic; D000140:Acidosis, Lactic / Q000139:chemically induced / Q000628:therapy*; D058186:Acute Kidney Injury / Q000139:chemically induced / Q000628:therapy*; D000293:Adolescent; D000927:Anticonvulsants / Q000627:therapeutic use; D015415:Biomarkers; D006259:Craniocerebral Trauma / Q000150:complications; D003402:Creatine Kinase / Q000097:blood; D004359:Drug Therapy, Combination; D004562:Electrocardiography; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D015228:Hypertriglyceridemia / Q000139:chemically induced / Q000628:therapy; D006993:Hypnotics and Sedatives / Q000008:administration & dosage / Q000009:adverse effects*; D007262:Infusions, Intravenous; D008297:Male; D009104:Multiple Trauma / Q000150:complications; D010951:Plasma Exchange; D015742:Propofol / Q000008:administration & dosage / Q000009:adverse effects*; D012206:Rhabdomyolysis / Q000097:blood / Q000139:chemically induced / Q000628:therapy*; D013226:Status Epilepticus / Q000188:drug therapy* / Q000209:etiology; D013577:Syndrome
chemical_list: D000927:Anticonvulsants; D015415:Biomarkers; D006993:Hypnotics and Sedatives; D003402:Creatine Kinase; D015742:Propofol
keywords: plasma exchange; propofol infusion syndrome