Propofol infusion syndrome

Efficacy of a prospective screening protocol

Thomas J. Schroeppel, L. Paige Clement, Danielle L. Barnard, Whitney Guererro, Margaret D. Ferguson, John P. Sharpe, Louis J. Magnotti, Martin Croce, Timothy C. Fabian

Research output: Contribution to journalArticle

Abstract

Propofol infusion syndrome (PIS) is a potentially lethal complication of propofol marked by rhabdomyolysis, metabolic acidosis, and cardiac arrhythmias or collapse. The objective of this study was to determine the effectiveness of a prospective screening protocol to prevent PIS. All trauma patients admitted who received propofol as a continuous infusion were prospectively screened from November 1, 2013 to December 31, 2015. Variables studied included demographics, injury severity, laboratory values, infusion rates, and mortality. Serum creatine phosphokinase (CPK) and lactate were drawn daily. Propofol was stopped for a positive screen defined as an increase in CPK to greater than 5000 IU/L or lactate greater than 4 mmol/L. Positive and negative cohorts were compared. Two hundred and twenty-five patients met the inclusion criteria and 12 patients (5.3%) had propofol stopped because of elevated CPK. No differences were identified in demographics, transfusions, injury severity, hospital length of stay, or propofol dose. The positive screened group had longer intensive care unit length of stay (20 vs 13 days; P = 0.002) and increased vent days (14.5 vs 10 days; P = 0.008). Max serum osmolality (334 vs 305 mosm/kg; P = 0.049) and max serum CPK (6782 vs 1058 IU/L; P < 0.0001) were higher in the positive cohort. No cases of PIS occurred, and mortality (16.7 vs 15.5%; P = 0.999) was not different between the cohorts. The screening protocol was effective in eliminating PIS. Serial CPK evaluations provided an effective screening tool and serum lactate can be dropped from screening.

Original languageEnglish (US)
Pages (from-to)1333-1338
Number of pages6
JournalAmerican Surgeon
Volume84
Issue number8
StatePublished - Aug 1 2018

Fingerprint

Propofol
Creatine Kinase
Lactic Acid
Length of Stay
Serum
Wounds and Injuries
Demography
Rhabdomyolysis
Mortality
Acidosis
Osmolar Concentration
Intensive Care Units
Cardiac Arrhythmias
Propofol Infusion Syndrome

All Science Journal Classification (ASJC) codes

  • Surgery

Cite this

Schroeppel, T. J., Clement, L. P., Barnard, D. L., Guererro, W., Ferguson, M. D., Sharpe, J. P., ... Fabian, T. C. (2018). Propofol infusion syndrome: Efficacy of a prospective screening protocol. American Surgeon, 84(8), 1333-1338.

Propofol infusion syndrome : Efficacy of a prospective screening protocol. / Schroeppel, Thomas J.; Clement, L. Paige; Barnard, Danielle L.; Guererro, Whitney; Ferguson, Margaret D.; Sharpe, John P.; Magnotti, Louis J.; Croce, Martin; Fabian, Timothy C.

In: American Surgeon, Vol. 84, No. 8, 01.08.2018, p. 1333-1338.

Research output: Contribution to journalArticle

Schroeppel, TJ, Clement, LP, Barnard, DL, Guererro, W, Ferguson, MD, Sharpe, JP, Magnotti, LJ, Croce, M & Fabian, TC 2018, 'Propofol infusion syndrome: Efficacy of a prospective screening protocol', American Surgeon, vol. 84, no. 8, pp. 1333-1338.
Schroeppel TJ, Clement LP, Barnard DL, Guererro W, Ferguson MD, Sharpe JP et al. Propofol infusion syndrome: Efficacy of a prospective screening protocol. American Surgeon. 2018 Aug 1;84(8):1333-1338.
Schroeppel, Thomas J. ; Clement, L. Paige ; Barnard, Danielle L. ; Guererro, Whitney ; Ferguson, Margaret D. ; Sharpe, John P. ; Magnotti, Louis J. ; Croce, Martin ; Fabian, Timothy C. / Propofol infusion syndrome : Efficacy of a prospective screening protocol. In: American Surgeon. 2018 ; Vol. 84, No. 8. pp. 1333-1338.
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