Linko Rita, Laukkanen Annika, Koljonen Virve, Rapola J, Varpula Tero
From the *Intensive Care Unit, Division of Anaesthesiology and Intensive Care Medicine, Department of Surgery, †Division of Plastic Surgery, Department of Surgery, and ‡Department of Cardiology, Helsinki University Central Hospital, Finland.
J Burn Care Res. 2014 Sep-Oct;35(5):e364-7. doi: 10.1097/BCR.0000000000000053.
The authors report a favorable outcome in an adult burn patient, who developed severe propofol-related infusion syndrome presenting with rhabdomyolysis, acute kidney injury, and right-sided heart failure after a low-dose propofol infusion. Other possible causes for late-onset rhabdomyolysis after burn trauma were ruled out by extensive differential diagnostics. The most distinctive abnormal finding was a Brugada-type ST-segment elevation, reported previously associating with imminent death. The patient survived because of cessation of propofol infusion and continuous renal replacement therapy. ECG recording is important in early detection of propofol-related infusion syndrome. ST elevations in the ECG should lead to the immediate discontinuation of propofol.
作者报告了一名成年烧伤患者的良好治疗结果,该患者在小剂量输注丙泊酚后出现严重的丙泊酚相关输注综合征,表现为横纹肌溶解、急性肾损伤和右侧心力衰竭。通过广泛的鉴别诊断排除了烧伤创伤后迟发性横纹肌溶解的其他可能原因。最显著的异常发现是Brugada型ST段抬高,此前报道其与濒死有关。由于停止输注丙泊酚并进行持续肾脏替代治疗,患者得以存活。心电图记录对于早期发现丙泊酚相关输注综合征很重要。心电图中的ST段抬高应导致立即停用丙泊酚。