john1900

1. Curr Opin Anaesthesiol. 2008 Oct;21(5):544-51. Update on the propofol infusion syndrome in ICU management of patients with head injury. Otterspoor LC, Kalkman CJ, Cremer OL. Department of Intensive Care, University Medical Centre Utrecht, Utrecht, The Netherlands. [email protected] PURPOSE OF REVIEW: The propofol infusion syndrome is a rare condition characterized by the occurrence of lactic acidosis, rhabdomyolysis and cardiovascular collapse following high-dose propofol infusion over prolonged periods of time. Patients with traumatic brain injury are particularly at risk of developing this complication because large doses of propofol are commonly used to control intracranial pressure, whereas vasopressors are administered to augment cerebral perfusion pressure. In this review, we provide an update on the literature with particular emphasis on patients with traumatic brain injury. RECENT FINDINGS: Several new case reports and reviews, as well as a number of experiments, have contributed significantly to our increased understanding of the cause of the syndrome. At the basis of the syndrome lies an imbalance between energy utilization and demand resulting in cell dysfunction, and ultimately necrosis of cardiac and peripheral muscle cells. Uncertainty remains whether a genetic susceptibility exists. Nonetheless, the growing number of case reports has made it possible to identify several risk factors. SUMMARY: Propofol infusion syndrome is a rare but frequently lethal complication of propofol use. In patients with risk factors, such as traumatic brain injury, it is suggested that an infusion rate of 4 mg/kg per hour should not be exceeded. Early warning signs include unexplained lactic acidosis, lipemia and Brugada-like ECG changes. When these occur, propofol infusion should be discontinued immediately. PMID: 18784477 [PubMed - indexed for MEDLINE]

Ive had no luck in contacting you on yahoo.let me know if my emails have gotten through or not. Thanks

Im so glad to hear your father survived the syndrome Before he died the nurse checked his pupils ,we were right there ,they were reacting normaly and equal.he just could not move physicaly or talk. I think our son to would have survived but the doctor's denied him survival care. They also denied he had the complication. There was little I could do about what happened to our son . I came here afterwards and tried to spread the word on this problem. It seems alot of hosptials know about this and avoid it. That is very good news.The hosptial where it happened was told about what we found out through a private doctor but has not responded(denial) in any way. From posts I have read about the hosptial I doubt they took any action whatever and it's probably still going on. The medical board found a doctor to refute all our doctor's findings including the PRIS.They told me they don't get involved in these issues.I also had little luck in persuing a case aginst Astrazenica although a attorney sat on it and called the day the statue expired and asked if I ever found another lawyer. The doctor who helped me said a blackbox warning is definitly needed to prevent further injurys and deaths.Im working with a major consumer magizine now to hopefully bring this issue forward.Our doctor feels it definitly is needed since it has gone generic.

Gay, We hope your father made it.Our son came down with it and the doctors gave up on him. he to never woke up after propofol was discontinued. A nurse came in and put him through pain tests and of course he never moved. He was parlized from the drug.They even discontinued his cardiovascular drug support unknown to us just before this .He died a few hours later after his heart went into asytole. What do professionals call when patients are put on comfort care without the families knowledge?

Here is new source I found.It identifies the syndrome very well. http://pt.wkhealth.com/pt/re/anesb/fulltext.00000524-200707000-00009.htm

This the latest warning from medwatch on propofol and the syndrome. http://www.fda.gov/medwatch/safety/2007/feb07.htm. There have been many more cases of this than reported mainly due to ignorance and the lack of warning from astra zenica. This has been known since 1992 .Norway was the first to recognize it.