propofol infusion syndrome

Do you have any information that propofol infusion syndrome is the same as fat overload syndrome?

I have never heard of this Propofol Infusion Syndrome till now. I've had pts who are on this gtt for weeks off and on. To me, pts on propofol wake up easily than any other drugs. Some common side effects of the drug are cardiac suppresion and high fat content and therefore not recommended for someone who has active pancreatitis.

Had a pt yesterday who was taken off propofol, due to propofol induced pancreatitis, and green urine (a ugly green too). Pt was having issues with DIC also. BUT this was the only thing that worked to decrease her ICP. After d/c the drip her ICP was in the 30-40 range all day with paramaters to keep less than 30. Versed and Fentanyl gtt's didn't work, mannitol didn't work either. I have today off so I have no idea what they did for her. So I can see why the drug is only for short term sedation.

Have they tried Barbituate coma yet. This would help reduce icp.

I am hoping that when I go in to work tomorrow morning that the intensivest team has tried this. I told 3 residents about the ICP not going down and that we were maxed out on paramaters for versed fentanyl gtt and also given mannitol and I ended up with orders for nicardipine. Worked well for BP but not ICP. I was going to suggest but it seemed like the residents were ignoring me. I am new to the ICU (have been medsurg for 5 yrs) and afraid to be too vocal. I just hope that they did something. It has been 3 days since last CT and pt CT after crani looked worse than before crani. Pt too unstable to travel since issues with DIC. I will see what happnes in the morning.

I have a question about using Diprivan off label for seizure suppression? I work in CCU and we had a pt that became hypotensive (sbp 50's). She was on continuous EEG monitoring, which we normally do not see in CCU. We normally turn off the Diprivan drip and call the physician if pt becomes hypotensive. We have critical care docs that are the primary, so I called the doc on call, updated him on events/condition and told him the Diprivan had been turned off. The pt was end stage renal on dialysis and Levo at the time. We started an Epi drip as per order. Her sbp temporarily increased 80-90's then dropped again. Further orders from physician was fluid bolus and cardiology consult in AM (d/t brady heart rate and widening of QRS). We also did 12 lead EKG. I also had the house officer come by to update her. This all happened around 3am.
Family was notified, they came in and decided at 7am to change code status to DNRCCA. When the neurologist came in that morning, he was irate that Diprivan had been turned off. He stated that it should not have been turned off because it was for seizure suppression.
Has anyone had any experience with this off label use of Diprivan? Thank you!!!

I've never heard of if being used for seizures, but regardless, if the SBP is in the 50's the propofol is coming off. I know where BP is in the ABCs, but possible seizure activty is nowhere near the top of my priority list when my pt is becoming hypotensive.

what happens in PRIS? The only real bad reaction i've seen in the ICU was Steven Johnson's.. Which was just devastating. Felt so bad for that pt & family.

Propofol isn't approved for pediatric ventiltor sedation. It is used but not commonly. The only syndrome experienced in adults is hypercholestremia.