Propofol infusion syndrome (PRIS) is a potentially lethal complication in ICU patients receiving prolonged high-dose propofol. The earliest metabolic indicator of PRIS is:

• A Hypernatremia
• B Respiratory alkalosis
• C Hypocalcemia
• D Lactic acidosis with anion gap elevation ✓

Explanation

Propofol impairs mitochondrial electron transport and fatty acid oxidation, leading to cellular energy failure and accumulation of lactate. The earliest and most characteristic laboratory finding in PRIS is a high anion-gap metabolic (lactic) acidosis. Other features include cardiac arrhythmias (especially right bundle branch block and ST elevation mimicking Brugada pattern), rhabdomyolysis, lipaemia, and renal failure. Risk increases at doses exceeding 4–5 mg/kg/h for more than 48 hours.

Reference: Morgan & Mikhail's Clinical Anesthesiology, 6th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.