Suggested beginning of propofol infusion syndrome in an adult patient without lactacidosis: a case report.

EDITOR: Propofol infusion syndrome (PRIS) is a rare and often fatal disease associated with propofol sedation at doses of more than 5 mg kg h for more than 48 h. PRIS is characterized by lipaemic plasma, fatty liver enlargement, metabolic acidosis, rhabdomyolysis or myoglobinuria, cardiac arrhythmia and acute bradycardia progressing to asystole. The syndrome usually occurs in patients with central nervous system damage on catecholamine and glucocorticoid therapy [1]. Recent reports described patients with non-fatal suspected PRIS initially presenting with lactacidosis. The symptoms included rhabdomyolysis, arrhythmia, metabolic acidosis and renal failure [2]. Lactacidosis has been discussed as an early sign of PRIS [3], but we present a report of a case of suspected PRIS without lactacidosis.