Propofol Infusion Syndrome: A Rare Complication From a Common Medication

Abstract

Propofol infusion syndrome (PRIS) is a multifactorial condition that, upon propofol administration, can interrupt critical cellular processes. This can lead to cellular damage that translates as multi-organ system failure that has the potential to be life-threatening. Due to the rarity of this condition, we report a case of PRIS in a 46-year-old male to help bring awareness to this severe condition caused by a relatively common medication. This patient was brought in due to unresponsiveness secondary to multi-substance abuse and respiratory disease and initially had elevated creatinine kinase levels that eventually subsided with appropriate management. However, after prolonged infusion of propofol, his creatinine kinase levels began to drastically rise, alluding to the development of propofol infusion syndrome. Once the offending agent was discontinued, the patient's creatinine kinase levels once again began to normalize.

Keywords: cellular and molecular biology; creatinine kinase; propofol based sedation; propofol infusion syndrome; rhabdomyolysis with acute renal failure.

Figure 1. EKG showed heart rate of 69, QTc of 411, normal sinus rhythm

Figure 2. Chest X-ray showing airspace opacities in the right mid and lower lung (arrows)

Figure 3. CT of the chest

CT Chest revealed extensive pulmonary parenchymal findings detailed above including consolidation of the right lower lobe (blue arrow) which was considered a combination of both atelectasis and infection. Mediastinal lymphadenopathy (red arrow) was noted in addition to axillary lymphadenopathy

Figure 4. A CT of the head was negative for acute changes (A and B)

Figure 5. A graph showing the trending creatinine kinase levels of the patient during the course of their admission. On 08/01/2022, propofol administration was discontinued