Propofol Infusion Syndrome

• Many of us are now using propofol for sedation in our critically ill patients
• Although a great drug, it is important to be aware of "propofol infusion syndrome" (PIS)
• Risk factors for PIS include young age, severe CNS or pulmonary illness, and exogenous catecholamine administration
• Clinical features include: unexplained metabolic acidosis, rhabdomyolysis, hyperlipidemia, hepatomegaly, and cardiovascular instability
• Pearl: It is reported that the development of coved ST elevations in V1-V3 (similar to Brugada syndrome) may be the first sign of cardiac instability with PIS

References

Kam PCA, Cardone D. Propofol infusion syndrome. Anaesthesia 2007;62:690-701.