두개내압 감압을 위한 Propofol 혼수 치료를 받는 성인 환자에서 발생한 Propofol 정주 증후군
Propofol-Related Infusion Syndrome in an Adult Patient UsingPropofol Coma Therapy to Control Intracranial Pressure
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Propofol-related infusion syndrome (PRIS) is a rare but fatal complication. Unexplained metabolic acidosis, rhabdomyolysis, hyperkalemia, myocardial dysfunction, cardiovascular collapse and acute kidney injury are the main characteristics of PRIS. Herein, we report a case of PRIS in a neurosurgical adult patient, who had received high-dose propofol continuous infusion in order to control intracranial pressure in an intensive care unit. She manifested severe metabolic acidosis, rhabdomyolysis, acute kidney injury and myocardial dysfunction. As soon as PRIS was diagnosed, propofol infusion was stopped. Conservative treatments, such as vasopressors and inotropics, continuous renal replacement therapy and extracorporeal membrane oxygenation were used to treat PRIS. However, she finally expired. This case report suggests that a great caution to PRIS is needed in a situation with high-dose propofol continuous infusion.
Abstract
Propofol-related infusion syndrome (PRIS) is a rare but fatal complication. Unexplained metabolic acidosis, rhabdomyolysis, hyperkalemia, myocardial dysfunction, cardiovascular collapse and acute kidney injury are the main characteristics of PRIS. Herein, we report a case of PRIS in a neurosurgical adult patient, who had received high-dose propofol continuous infusion in order to control intracranial pressure in an intensive care unit. She manifested severe metabolic acidosis, rhabdomyolysis, acute kidney injury and myocardial dysfunction. As soon as PRIS was diagnosed, propofol infusion was stopped. Conservative treatments, such as vasopressors and inotropics, continuous renal replacement therapy and extracorporeal membrane oxygenation were used to treat PRIS. However, she finally expired. This case report suggests that a great caution to PRIS is needed in a situation with high-dose propofol continuous infusion.
참고문헌 (19)
- Hughes MA, "Context-sensitive half-time in multicompartment pharmacokinetic models for intravenous anesthetic drugs", Anesthesiology, 76, pp.334~341 (1992)
- Fodale V, "Propofol infusion syndrome: an overview of a perplexing disease", Drug Saf, 31, pp.293~303 (2008)
- Cremer OL, "Long-term propofol infusion and cardiac failure in adult head-injured patients", Lancet, 357, pp.117~118 (2001)
- Pinaud M, "Effects of propofol on cerebral hemodynamics and metabolism in patients with brain trauma", Anesthesiology, 73, pp.404~409 (1990)
- Roberts RJ, "Incidence of propofol-related infusion syndrome in critically ill adults: a prospective, multicenter study", Crit Care, 13, pp.R169~ (2009)
- Bray RJ, "Propofol infusion syndrome in children", Paediatr Anaesth, 8, pp.491~499 (1998)
- Kang TM, "Propofol infusion syndrome in critically ill patients", Ann Pharmacother, 36, pp.1453~1456 (2002)
- Loh NW NP, "Propofol infusion syndrome", Contin Educ Anaesth Crit Care Pain, ~ (2013)
- Papaioannou V, "The propofol infusion ‘syndrome' in intensive care unit: from pathophysiology to prophylaxis and treatment", Acta Anaesthesiol Belg, 59, pp.79~86 (2008)
- Perrier ND, "Death related to propofol use in an adult patient", Crit Care Med, 28, pp.3071~3074 (2000)
- Vasile B, "The pathophysiology of propofol infusion syndrome: a simple name for a complex syndrome", Intensive Care Med, 29, pp.1417~1425 (2003)
- 임윤희, "Experience of Suspected Propofol Infusion Syndrome in a Status Epilepticus Patient", Korean Journal of Anesthesiology, 53(3), pp.58~60 (2007), 대한마취통증의학회
- Yoon CW, "Propofol infusion syndrome in a patient with epilepsia partialis continua", J Korean Epilepsy Soc, 15, pp.31~33 (2011)
- Parke TJ, "Metabolic acidosis and fatal myocardial failure after propofol infusion in children: five case reports", BMJ, 305, pp.613~616 (1992)
- Kam PC, "Cardone D : Propofol infusion syndrome", Anaesthesia, 62, pp.690~701 (2007)
- Burow BK, "Metabolic acidosis associated with propofol in the absence of other causative factors", Anesthesiology, 101, pp.239~241 (2004)
- Haase R, "Lactic acidosis following short-term propofol infusion may be an early warning of propofol infusion syndrome", J Neurosurg Anesthesiol, 17, pp.122~123 (2005)
- Salengros JC, "Lactic acidosis during propofol-remifentanil anesthesia in an adult", Anesthesiology, 101, pp.241~243 (2004)
- Lee JI KY, "Clinical comparison between barbiturate and propofol coma therapy in the patients with severe traumatic brain injury", J Korean Neurotraumatol Soc, 4, pp.24~30 (2008)