Short-term propofol infusion syndrome (PRIS): fact or fiction? A systematic review on early PRIS in intensive care and anesthesia

Excerpt

Propofol infusion syndrome (PRIS) is a rare propofol complication, leading to cardiac failure. It was first described in critically ill children and in adults with traumatic brain injury. Pathophysiology is unknown although common factors are the prolonged (>48 hours) use of high-dose (>5 mg/kg/hour) propofol combined with elevated levels of catecholamines and corticosteroids. Recently, case reports of early-onset PRIS during anesthesia and in the early postoperative setting were published. In many of these, lactic acidosis is interpreted as onset of PRIS. Criticism offers that it might concern a poor differential diagnostic approach or an observational bias. Also, lactic acidosis is not an obligate PRIS symptom and incidence of lactic acidosis during propofol sedation is unknown. To gain insight into the incidence and characteristics of early PRIS, we performed a systematic review on early PRIS cases. …