Propofol infusion syndrome risk factors include which scenario?

Propofol infusion syndrome risk factors include which scenario?

• A. Elderly patient with low-dose infusion for a short period
• B. Children receiving high doses (>4 mg/kg/hr) for longer than 48 hours
• C. Adults undergoing brief procedures
• D. Patients with normal lipids receiving standard infusion

Answer: (B)

Propofol infusion syndrome arises mainly from prolonged, high-dose exposure to propofol. The risk goes up when the infusion is given at a high rate for an extended period because propofol can impair mitochondrial fatty acid oxidation and oxidative phosphorylation, leading to energy failure in slick tissues like the heart, skeletal muscle, liver, and adipose tissue. This is especially true in children, who may have limited metabolic reserve or undiagnosed fatty acid oxidation disorders, making them more susceptible to the metabolic and cardiac complications seen with PRIS. The scenario described—a child receiving a high dose (>4 mg/kg/hr) for more than 48 hours—fits this high-risk pattern best. In contrast, an elderly patient on a low-dose, short infusion, adults undergoing brief procedures, or patients with normal lipids on standard infusion have far lower risk for PRIS.

Propofol infusion syndrome arises mainly from prolonged, high-dose exposure to propofol. The risk goes up when the infusion is given at a high rate for an extended period because propofol can impair mitochondrial fatty acid oxidation and oxidative phosphorylation, leading to energy failure in slick tissues like the heart, skeletal muscle, liver, and adipose tissue. This is especially true in children, who may have limited metabolic reserve or undiagnosed fatty acid oxidation disorders, making them more susceptible to the metabolic and cardiac complications seen with PRIS. The scenario described—a child receiving a high dose (>4 mg/kg/hr) for more than 48 hours—fits this high-risk pattern best. In contrast, an elderly patient on a low-dose, short infusion, adults undergoing brief procedures, or patients with normal lipids on standard infusion have far lower risk for PRIS.