Department of Intensive Care, University of Groningen, University Medical Centrum Groningen, Hanzeplein 1, 9700 RB Groningen, The Netherlands.
Neurocrit Care. 2012 Oct;17(2):260-4. doi: 10.1007/s12028-012-9743-8.
Propofol infusion syndrome (PRIS) is well known, often associated with, lethal complication of sedation with propofol. PRIS seems to be associated with young age, traumatic brain injury (TBI), higher cumulative doses of propofol, and the concomitant use of catecholamines. Known manifestations of PRIS are metabolic acidosis, rhabdomyolysis, and cardiac failure. While fatal PRIS can occur suddenly and rapidly, there is no sensitive test or early warning sign, and the only preventive measure is to limit propofol dosage and its duration.
DESCRIPTION OF A SINGLE CASE: A case report was used for investigation purposes of this study.
We report the case study of a young patient with severe TBI, receiving propofol sedation because of high intracranial pressure. Seven days after the trauma, the patient developed metabolic acidosis and refractory circulatory shock, probably caused by PRIS. Reversal of T-waves was seen on the electrocardiogram (ECG) 29 h before circulation failure occurred. In the absence of other signs of cardiac dysfunction or ischemia, these reversed T-waves probably represent an early warning sign of developing PRIS.
From the findings of this study, we conclude that meticulous observation and analysis of the ECG during propofol sedation might result in earlier recognition of developing PRIS.
丙泊酚输注综合征（PRIS）是一种众所周知的并发症，常与丙泊酚镇静相关，且具有致命性。PRIS 似乎与年龄较小、创伤性脑损伤（TBI）、丙泊酚累积剂量较高以及同时使用儿茶酚胺有关。PRIS 的已知表现为代谢性酸中毒、横纹肌溶解和心力衰竭。虽然致命性 PRIS 可能突然迅速发生，但目前没有敏感的检测或早期预警信号，唯一的预防措施是限制丙泊酚的剂量和使用时间。
采用病例报告的方法进行研究。
我们报告了一例年轻患者的病例研究，该患者因颅内压升高而接受丙泊酚镇静。创伤后 7 天，患者出现代谢性酸中毒和难治性循环性休克，可能是由 PRIS 引起的。在循环衰竭发生前 29 小时，心电图（ECG）上出现 T 波反转。在没有其他心脏功能障碍或缺血的迹象的情况下，这些反转的 T 波可能代表 PRIS 发展的早期预警信号。
根据本研究的结果，我们得出结论，在丙泊酚镇静期间对心电图进行仔细观察和分析可能会更早地识别出 PRIS 的发生。
