VA-ECMO rescue therapy in propofol infusion syndrome after cardiac surgery.
Perfusion
; 38(4): 868-871, 2023 05.
Article
em En
| MEDLINE
| ID: mdl-35225086
ABSTRACT
INTRODUCTION:
Propofol infusion syndrome (PRIS) is a rare entity that could lead to profound cardiogenic shock (CS). Mitochondrial toxicity and sympathetic blockade are the mechanisms leading to CS in PRIS. CASE REPORT We present a 22-year-old woman who developed refractory CS due to PRIS after aortic valve replacement surgery secondary to Coxiella infective endocarditis. She was rescued with VA-ECMO (veno-arterial extracorporeal membrane oxygenation) and was discharged 2 months later with no cardiac dysfunction.DISCUSSION:
PRIS diagnosis is difficult even though propofol is frequently used in critical care units. Abrupt refractory CS in patients with recent use of high doses of propofol (> 4 mg/Kg/h) together with rhabdomyolysis should raise the suspicion. Diagnostic confirmation is based on muscle biopsy and fat enzyme analysis.CONCLUSION:
Propofol withdrawal and support therapies-including VA-ECMO-are the treatment of choice in severe PRIS. VA-ECMO could increase survival as a bridge to recovery due to reversibility of PRIS.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Oxigenação por Membrana Extracorpórea
/
Propofol
/
Síndrome da Infusão de Propofol
/
Procedimentos Cirúrgicos Cardíacos
Limite:
Adult
/
Female
/
Humans
Idioma:
En
Revista:
Perfusion
Assunto da revista:
CARDIOLOGIA
Ano de publicação:
2023
Tipo de documento:
Article
País de afiliação:
Espanha