Propofol infusion syndrome in a super morbidly obese patient (BMI = 75)

Propofol infusion syndrome (PRIS) is a rare but often fatal complication as a result of large doses of propofol infusion (4–5 mg/kg/hr) for a prolonged period (>48 h). It has been reported in both children and adults. Besides large doses of propofol infusion, the risk factors include young age, acute neurological injury, low carbohydrate and high fat intake, exogenous administration of corticosteroid and catecholamine, critical illness, and inborn errors of mitochondrial fatty acid oxidation. PRIS manifestation include presence of metabolic acidosis with a base deficit of more than 10 mmol/l at least on one occasion, rhabdomyolysis or myoglobinuria, acute renal failure, sudden onset of bradycardia resistant to treatment, myocardial failure, and lipemic plasma. The pathophysiology of PRIS may be either direct mitochondrial respiratory chain inhibition or impaired mitochondrial fatty acid metabolism mediated by propofol. We report a case of supermorbidly obese patient who received propofol infusion by total body weight instead of actual body weight and developed PRIS.

Diary 48 August 1898-February 1899 (XML)

A journal of commercial voyages and domestic life on the Tigris River from August 1898 to February 1899. jms_048_08_1898_010_xml.xml

Joseph Mathia Svoboda Tigris River Journal; Diary 48 August 1898-February 1899 (HTML)

Joseph Mathia Svoboda's 19th century journal of commercial voyages, travel, and domestic life on the Tigris River from August 1898-February 1899. Diary 48, HTML Version. jms_048_08_1898_030_htm.html

Diary 48 August 1898-February 1899 (TXT)

A journal of commercial voyages and domestic life on the Tigris River from August 1898 to February 1899. jms_048_08_1898_020_trf.txt

Diary 48 August 1898-February 1899 (Summary)

A journal of commercial voyages and domestic life on the Tigris River from August 1898 to February 1899. jms_048_08_1898_040_sum.html

Diary 48 August 1898-February 1899 (TEX)

A journal of commercial voyages and domestic life on the Tigris River from August 1898 to February 1899. jms_048_08_1898_050_tex.tex

Joseph Mathia Svoboda Tigris River Journal; Diary 48 August 1898-February 1899 (PDF)

Joseph Mathia Svoboda's 19th century journal of commercial voyages, travel, and domestic life on the Tigris River from August 1898-February 1899. Diary 48, PDF Version. jms_048_08_1898_060_pdf.pdf

Diary 48 August 1898-February 1899 (XLSX)

A journal of commercial voyages and domestic life on the Tigris River from August 1898 to February 1899. jms_048_08_1898_110_arb.xlsx

Diary 48 August 1898-February 1899 (Arabic)

A journal of commercial voyages and domestic life on the Tigris River from August 1898 to February 1899. Arabic translations. jms_048_08_1898_120_arb.html

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A journal of commercial voyages and domestic life on the Tigris River from August 1898 to February 1899. jms_048_08_1898_150_wla.txt

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A journal of commercial voyages and domestic life on the Tigris River from August 1898 to February 1899. jms_048_08_1898_160_csv.csv

Diary 48 August 1898-February 1899 (Summary)

A journal of commercial voyages and domestic life on the Tigris River from August 1898 to February 1899. jms_049_02_1899_040_sum.html