Abstract
Review of the literature shows no standard of care for the treatment of propofol infusion syndrome. Our case shows a potential therapeutic approach to cure lactate acidosis caused by propofol, which is a rare but life-threatening complication in (pediatric) intensive care patients. We report the case of a 9-year-old, healthy boy who suffered an inhalative trauma after a fire in his parents’ apartment. Following sedation in the pediatric intensive care unit with propofol (5 mg/kg/h) for a duration of less than 48 h, he developed laboratory findings consistent with propofol infusion syndrome. Due to lactate acidosis and a suspected cyanide intoxication the patient received hydroxocobalamin. The lactate acidosis resolved seven hours after treatment. Hydroxocobalamin should be evaluated for the treatment of propofol infusion syndrome for its potential to prevent mitochondrial apoptosis caused by reactive oxygen species generation in the electron transportation chain. Hydroxocobalamin should thus be considered in other entities of drug induced disruption of the electron transportation chain causing lactate acidosis as well.
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Patient data is reported anonymized; the underlying data is stored in the KIS of the original hospital. No other data about this case has been reported elsewhere.
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Abbreviations
- ALT :
-
Alanine-aminotransferase
- AST :
-
Aspartate-aminotransferase
- CK :
-
Creatine kinase
- COHb :
-
Carboxyhemoglobin
- ECG :
-
Electrocardiogram
- ETC:
-
Electron transport chain
- FiO2 :
-
Inspiratory oxygen concentration
- LDH :
-
Lactate dehydrogenase
- PICU:
-
Pediatric intensive care unit
- pO2 :
-
Partial pressure of oxygen
- PRIS :
-
Propofol-infusion-syndrome
- ROS:
-
Reactive oxygen species
- RSI :
-
Rapid sequence induction
- %TBSA:
-
Total body surface area
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L. Lindemann conceived and wrote the article. PD Dr. med. S. Frees edited the article. All authors read and approved the article.
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Lindemann, L., Frees, S. Could Hydroxocobalamin Be of Use in the Treatment of Lactate Acidosis Induced by Propofol Infusion Syndrome? - A Case Report. SN Compr. Clin. Med. 4, 204 (2022). https://doi.org/10.1007/s42399-022-01286-y
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DOI: https://doi.org/10.1007/s42399-022-01286-y