medigraphic.com
ISSN 3061-8142 (Electronic)
ISSN 0484-7903 (Print)

2023, Number 1

<< Back Next >>

Rev Mex Anest 2023; 46 (1)

Propofol and COVID-19 infusion syndrome. Case report

Espinoza MI, Becerra-Martínez DI, Guzmán-García ÁM, Verea-Martínez B, Carrillo-Esper R, Franco-del AD

Language: Spanish
References: 12
Page: 61-66
PDF size: 380.10 Kb.


ABSTRACT

The severe form of SARS-CoV-2 pneumonia (COVID-19) occurs in most cases with acute respiratory distress syndrome (ARDS), requiring the use of sedation during mechanical ventilation, with propofol being the most widely used for its pharmacokinetics and pharmacodynamics. Propofol is a widely used anesthetic in intensive care units (ICU). Its use can cause an infrequent but extremely serious adverse effect, known as propofol infusion syndrome (PRIS), which is closely associated with the speed of infusion coupled with risk factors specific to the patient, the clinical features of PRIS are hemodynamic instability, lactic acidosis and with progression to multi-organ dysfunction. We present a case of SIP in a patient with acute respiratory distress syndrome (ARDS) secondary to SARS-CoV-2 who develops this complication associated with sedation, discusses clinical pathophysiology and considerations that should be taken into account when using it in continuous infusion.


REFERENCES

  1. World Health Organization. Novel Coronavirus (2019-nCoV) technical guidance. WHO. Available in: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/technical-guidance

  2. CDC. Interim infection prevention and control recommendations for patients with confirmed 2019 novel coronavirus (2019-nCoV) or persons under investigation for 2019-ncov in healthcare settings. 2020.

  3. Sun Q, Qiu H, Huang M. Lower mortality of COVID-19 by early recognition and intervention: experience from Jiangsu province. Ann Intensive Care. 2020;10:33. Available in: https://doi.org/10.1186/s13613-020-00650-2

  4. Krajeová A, Waldauf P, Andil M, et al. Propofol infusion syndrome: a structured review of experimental studies and 153 published case reports. Crit Care. 2015;19:398-407.

  5. Otterspoor LC, Kalkman CJ, Cremer OL. Update on thepropofol infusion syndrome in ICU management of patientswith head injury. Curr Opin Anaesthesiol. 2008;21:544-551.

  6. Cremer OL, Moons KG, Bouman EA, et al. Long-term propofol infusion and cardiac failure in adult head-injured patients. Lancet. 2001;357:117-118.

  7. Fresenius Kabi. Diprivan (propofol 1%) injectable emulsion USP. Lake Zurich, IL. 2017:1-54.

  8. EMA. Diprivan 1% e 2% (propofol). Lake Drive, Ireland: Aspen Pharma; 2017.

  9. Fudickar A, Bein B, Tonner PH. Propofol infusion syndrome in anaesthesia and intensive care medicine. Curr Opin Anaesthesiol. 2006;19:404-410.

  10. Mirrakhimov AE, Voore P, Halytskyy O, et al. Propofol infusion syndrome in adults: a clinical update. Crit Care Res Pr. 2015;2015:1-10.

  11. Roberts RJ, Barletta JF, Fong JJ, et al. Incidence of propofol-related infusion syndrome in critically ill adults: a prospective, multicenter study. Crit Care. 2009;13:169-179.

  12. Corbett SM, Moore J, Rebuck JA, et al. Survival of propofol infusion syndrome in a head-injured patient. Crit Care Med. 2006;34:2479-2483.




2020     |     www.medigraphic.com