Abstract
We report a case of propofol infusion syndrome (PRIS) in a young female treated for status epilepticus. In this case, PRIS rapidly evolved to full cardiovascular collapse despite aggressive supportive care in the intensive care unit, as well as prompt discontinuation of the offending agent. She progressed to refractory cardiac arrest requiring emergent initiation of venoarterial extracorporeal membrane oxygenation (ECMO) during cardiopulmonary resuscitation (CPR). She regained a perfusing rhythm after prolonged (>8 hours) asystole, was weaned off ECMO and eventually all life support, and was discharged to home. We also present a review of the available literature on the use of ECMO for PRIS.
Highlights
Propofol infusion, frequently used in the intensive care setting for sedation or for refractory status epilepticus, has been associated with a rare, but grave complication: propofol infusion syndrome (PRIS)
We describe a case of severe PRIS that was successfully resuscitated with extracorporeal membrane oxygenation (ECMO), despite prolonged evidence of cardiopulmonary arrest
8 hours after transfer, the patient suffered an episode of unstable ventricular tachycardia (V-tach) requiring three defibrillation attempts (200 Joules biphasic) without cardiopulmonary resuscitation (CPR) resulting in return of a sinus tachycardia with a persistent right bundle branch block (RBBB) and septal lead ST-segment depression (Figure 1C)
Summary
Frequently used in the intensive care setting for sedation or for refractory status epilepticus, has been associated with a rare, but grave complication: propofol infusion syndrome (PRIS). 8 hours after transfer, the patient suffered an episode of unstable ventricular tachycardia (V-tach) requiring three defibrillation attempts (200 Joules biphasic) without CPR (maintained pulse) resulting in return of a sinus tachycardia with a persistent right bundle branch block (RBBB) and septal lead ST-segment depression (Figure 1C) She was loaded with amiodarone and given aggressive calcium/magnesium replacements. At approximately 16:30 that evening, 18 hours after transfer, the patient suffered another V-tach episode, this time pulseless, requiring 10 minutes of CPR, 6 (1 mg) doses of epinephrine, defibrillations, and 100 mg of IV lidocaine with return of spontaneous circulation She remained in an accelerated junctional rhythm/V-tach with a perfusing blood pressure (101/64 mmHg, heart rate 135 beats per minute). She was transferred from our hospital to rehabilitation after 84 days of hospitalization
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
