Pneumotox » Drug » Propofol

Propofol

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Propofol can produce the Propofol Infusion Syndrome (PRIS), which may include rhabdomyolysis, arrhythmias, respiratory failure, metabolic acidosis, cardiovascular collapse, cardiac arrest and pulmonary edema. Propofol may cause addiction. Health care workers are exposed, due to easy access to the drug (PMID: 19567716, 24314538)

Last update : 08/05/2015

II.a Pulmonary edema, noncardiogenic (NCPE)

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II.b ARDS - Acute lung injury

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II.f Hypoxemia, low oxygen saturation (may occur in isolation)

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II.i Flash (fulminate) pulmonary edema

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IV.a Bronchospasm - Wheezing - Asthma

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IV.b Bronchospasm and angioedema

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IV.d Cough (lone)

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IV.e Cough (acute, violent, explosive)

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IV.f Severe or catastrophic bronchospasm or asthma attack (can be fatal)

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VI.e Fat/oil embolism - The FES embolism syndrome

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VIII.h Vocal cord dysfunction, adduction, closure, injury

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IX.d Respiratory failure from ventilatory depression (due to neuromuscular blockade/paralysis)

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IX.i Respiratory arrest - Apnea

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IX.p Disordered breathing during sleep - Sleep apnea

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X.f Anaphylaxis-Anaphylactoid reaction (can be fatal)

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X.u Multiple organ dysfunction/failure (MODS/MOF)

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X.aa Propofol infusion syndrome (PRIS)

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XI.d Metabolic acidosis (incl. lactic acidosis/-gap). May cause hyperpnea/dyspnea

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XI.r Death following exposure or poisoning

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XI.x Addictive risk

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XII.a Left or biventricular dysfunction/failure

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XII.m Cardiac- cardiorespiratory/pulmonary arrest

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XII.n Cardiovascular collapse - Cardiogenic shock - Hypotension

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XII.w Asystole

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XV.ae Path: Lipid/fat embolism (see also VIe)

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XXIV.h Veterinary: Anaphylaxis/Anaphylactoid reaction

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Diagnosing DIRD

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Drug and radiation history

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Drug singularity - Correct identification of the drug

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Consistent timing of exposure v. onset of symptoms

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Clinical, imaging, BAL, pathological pattern consistent with the specific drug

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Careful exlusion of another cause

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Remission of symptoms with removal of drug

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Recurrence with rechallenge (rarely advisable)

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Causality assessment

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