PROPOFOL-INDUCED METABOLIC DISTRESS SYNDROME

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Abstract

Introduction. The obtained experience of using propofol under clinical conditions and in experimental studies discover the mechanism of a negative drug effect at the level of mitochondrial enzymes which is currently treated as the propofol infusion syndrome.

Purpose. To demonstrate the cases of creatine phosphokinase level variation during the intraoperative pediatric use of propofol in anesthesia.

Materials and methods. Three cases of intraoperative use of propofol in 2–17‑years-old patients with different dosages and dose schedules.

Results. The level of creatine phosphokinase was increased 9–44 times within 2–5 days of postoperative period without any significant disturbances or with insignificant changes in the levels of transaminase and lactic dehydrogenase (LDG).

Conclusion. Propofol-based variation in the cellular metabolism proven today rather corresponds to the term ‘propofol-induced metabolic distress syndrome’. It can be manifested both at the level of clinical symptoms and subclinically, without any evident clinical signs with short-term transient variations of laboratory parameters only (acid-base balance (ABB), transaminase, LDG and CPK).

About the authors

V. V. Lazarev

Pirogov Russian National Research Medical University

Author for correspondence.
Email: 1dca@mail.ru

LAZAREV Vladimir Viktorovich –  M. D., Ph.D., Professor, Chairman of the Department of Pediatric Anesthesiology and Intensive Care

Ostrovityanova str., 1, Moscow, 117997

Россия

S. A. Daryin

Russian Children's Clinical Hospital

Email: 1dca@mail.ru

DARYIN Sergei Andreevich – Reanimatologist of pediatric intensive care unit

Moscow

Россия

G. P. Brusov

Russian Children's Clinical Hospital

Email: 1dca@mail.ru

BRUSOV Gleb Pavlovich – Chairman of pediatric intensive care unit

Moscow

Россия

L. E. Tsypin

Pirogov Russian National Research Medical University

Email: 1dca@mail.ru

TSYPIN Leonid Efimovich – M. D., Ph.D., Professor, Professor of the Department of Pediatric Anesthesiology and Intensive Care

Moscow

Россия

T. G. Popova

Pirogov Russian National Research Medical University

Email: 1dca@mail.ru

POPOVA Tatiana Georgievna – M. D., Ph.D., Associate Professor of the Department of Pediatric Anesthesiology and Intensive Care

Moscow

Россия

References

  1. Krajčová A., Waldauf P., Anděl M., Duška F. Propofol infusion syndrome: a structured review of experimental studies and 153 published case reports // Crit Care. 2015;19:398.
  2. Merz T. M., Regli B., Rothen H. U., Felleiter P. Propofol infusion syndrome a fatal case at a low infusion rate // Anesth Analg. 2006;103:1050.
  3. Zarovnaya E. L., Jobst B. C., Harris B. T. Propofol-associated fatal myocardial failure and rhabdomyolysis in an adult with status epilepticus // Epilepsia. 2007;48:1002–6.
  4. Bordes J., Meaudre E., Asencio Y. et al. Lactic acidosis associated with propofol during general anaesthesia for neurosurgery // Ann Fr Anesth Reanim. 2008;27:261–4.
  5. Mirrakhimov A. E., Voore P., Halytskyy O. et al. Propofol Infusion Syndrome in Adults: A Clinical Update // Critical Care Research and Practice. Volume 2015, Article ID 260385, 10 p. http://dx.doi.org/10.1155/2015/260385.
  6. Vanlander A. V., Okun J. G., de Jaeger A. et al. Possible pathogenic mechanism of propofol infusion syndrome involves coenzyme q // Anesthesiology. 2015; 122 (2):343–52. doi: 10.1097/ALN.0000000000000484.
  7. Muravchick S., Levy R. J. Clinical implications of mitochondrial dysfunction // Anesthesiology. 2006; 105 (4): 819–37. [PubMed: 17006082].
  8. Лазарев В. В., Быстрова А. А., Брюсов Г. П., Цыпин Л. Е., Попова Т. Г. Атипичная манифестация синдрома инфузии пропофола у ребенка 6 месяцев // Российский вестник детской хирургии, анестезиологии и реаниматологии. 2018; 8 (1):75–79.
  9. Farag E., Deboer G., Cohen B. H., Niezgoda J. Metabolic acidosis due to propofol infusion // Anesthesiology. 2005; 102 (3):697–8. Author reply 8–9. [PubMed: 15731621].

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Copyright (c) 2018 Lazarev V.V., Daryin S.A., Brusov G.P., Tsypin L.E., Popova T.G.

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