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en wikipedia org wiki Propofol_infusion_syndromeSummary: The propofol infusion syndrome (PRIS) is a very rare, undesired adverse effect of sedation with propofol that occurs most frequently in children Despite the fact that a number of fatal cases documented, the syndrome is still rela-tively unknown resusnation com propofol-infusion-syndromefirst10em com propofol-related-infusion-syndrome-prisPRIS is an uncommon but serious complication that usually arises in patients undergoing prolonged propofol infusions, especially those receiving higher doses The precise mechanisms behind PRIS are intricate and remain under active investigation Background PRIS = propofol infusion syndrome Refractory bradycardia and cardiovascular collapse Poorly understood mechanism Risk factors High doses of (> 4mg kg hr or 67 mcg kg min) Long duration (> 48 hrs) Younger age (PRIS first recognized in pediatric population) Critical illness Malnutrition Liver disease Carnitine deficiency Mitochondrial med virginia edu ginutrition wp-content uploads sites 199 MikeArticle pdfanesthesiologydfw com propofol-related-infusion-syndromePropofol-related infusion syndrome (PRIS) is a rare but severe condition associated with the administration of propofol, an anesthetic commonly used for sedation in medical procedures First identified in the 1990s, PRIS can be fatal if not recognized and treated promptly Mechanism of PRIS High doses of propofol (greater than 3mg kg h) lead to direct inhibition and uncoupling of mitochondrial electron transport chains, leading to greater reliance on anaerobic metabolism Propofol-related infusion syndrome (PRIS) is a lethal condition characterized by multiple organ system failures It can occur due to prolonged administration of propofol (an anesthetic) in mechanically intubated patients Initial definition of PRIS Defined as acute refractory bradycardia leading to asystole in the presence of one or more of the following:Propofol infusion syndrome (PRIS) is a rare syndrome which affects patients undergoing long-term treatment with high doses of the anaesthetic and sedative drug propofol PRIS was defined as metabolic acidosis plus cardiac dysfunction and at least one other variable including the fact that hypertriglyceridemia, rhabdomyolysis, and acute kidney injury occurred after the start of propofol litfl com propofol-related-infusion-syndromePropofol-related Infusion Syndrome (PRIS) is a life-threatening condition characterised by acute refractory bradycardia progressing to asystole and one or more of:pmc ncbi nlm nih gov articles PMC9671386Mechanism of PRIS High doses of propofol (greater than 3mg kg h) lead to direct inhibition and uncoupling of mitochondrial electron transport chains, leading to greater reliance on anaerobic metabolism Propofol infusion syndrome (PRIS) is a rare and potentially fatal condition that was first reported in children in 1990 It is characterized by profound metabolic acidosis and bradycardia which may ultimately lead to cardiac arrest pmc ncbi nlm nih gov articles PMC4410753The term PRIS—propofol infusion syndrome— was originally coined by Bray in 1998 to de-scribe the adverse effects associated with the use of propofol in the paediatric population If PRIS is suspected, propofol should be discontinued and an alterna-tive sedative agent initiated General measures to support cardiac and renal function should be initiated promptly in patients with suspected PRIS Aside from propofol dose, other risk factors for PRIS include critical illness, use of vasopressors and steroids, starvation or malnutrition, and subclinical mitochondrial disease wikem org wiki Propofol_infusion_syndromecumming ucalgary ca CPT%20Pearl%20Propofol%20Related%20Infusion%20Syndrom Both catecholamine and glucocorticoid administration are associated with the development of PRIS It is recommended to discontinue these medications if possible while on propofol infusion or select an alternative sedative if they cannot be discontinued If PRIS is suspected, propofol should be discontinued and an alterna-tive sedative agent initiated General measures to support cardiac and renal function should be initiated promptly in patients with suspected PRIS
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