{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T11:15:24Z","timestamp":1789038924719,"version":"build-2803163510"},"reference-count":21,"publisher":"BMJ","issue":"2","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2023,1,26]]},"published-print":{"date-parts":[[2023,2]]},"abstract":"<jats:p>An elderly man presenting with shortness of breath and hypoxaemia was admitted with acute hypoxic respiratory failure secondary to COVID-19 pneumonia. Due to worsening hypoxaemia, he was transferred to the intensive care unit and required mechanical ventilation. Propofol was infused at 1.5\u20134\u2009mg\/kg\/hour. Within 48 hours of initiation, we noticed worsening metabolic acidosis, acute kidney injury, hyperkalaemia, hyperphosphataemia, hypertriglyceridaemia, elevated creatine kinase and elevated myoglobin levels. Suspecting propofol-related infusion syndrome (PRIS), we discontinued his propofol infusion immediately and initiated supportive measures. In 48 hours, there was a significant improvement in metabolic acidosis, hypertriglyceridaemia, rhabdomyolysis and renal function. The propofol infusion rate and cumulative propofol dosage (under 140\u2009mg\/kg) were well below levels associated with PRIS. COVID-19\u2019s pathogenesis, still under investigation, may have contributed to this presentation. It is imperative for clinicians to maintain a high degree of suspicion once propofol is initiated, regardless of the cumulative dose or rate of infusion.<\/jats:p>","DOI":"10.1136\/bcr-2022-249456","type":"journal-article","created":{"date-parts":[[2023,2,7]],"date-time":"2023-02-07T12:11:09Z","timestamp":1675771869000},"page":"e249456","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Unusual case of propofol-related infusion syndrome complicating severe COVID-19 ARDS"],"prefix":"10.1136","volume":"16","author":[{"given":"Vedesh Kumar","family":"Babu","sequence":"first","affiliation":[{"name":"Internal Medicine Residency, Texas Tech University Health Sciences Center School of Medicine, Odessa, Texas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pedro","family":"Rojas","sequence":"additional","affiliation":[{"name":"Internal Medicine Residency, Texas Tech University Health Sciences Center School of Medicine, Odessa, Texas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Genesis","family":"Perez Del Nogal","sequence":"additional","affiliation":[{"name":"Internal Medicine Residency, Texas Tech University Health Sciences Center School of Medicine, Odessa, Texas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alejandra","family":"Garcia-Fernandez","sequence":"additional","affiliation":[{"name":"Internal Medicine Residency, Texas Tech University Health Sciences Center School of Medicine, Odessa, Texas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2023,2,7]]},"reference":[{"key":"2025082801510777000_16.2.e249456.1","doi-asserted-by":"crossref","first-page":"448","DOI":"10.1016\/j.bja.2018.12.025","article-title":"Propofol infusion syndrome: a structured literature review and analysis of published case reports","volume":"122","author":"Hemphill","year":"2019","journal-title":"Br J Anaesth"},{"key":"2025082801510777000_16.2.e249456.2","doi-asserted-by":"crossref","DOI":"10.1186\/cc8145","article-title":"Incidence of propofol-related infusion syndrome in critically ill adults: a prospective, multicenter study","volume":"13","author":"Roberts","year":"2009","journal-title":"Crit Care"},{"key":"2025082801510777000_16.2.e249456.3","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2044.2007.05055.x"},{"key":"2025082801510777000_16.2.e249456.4","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0b013e3181b08ac7"},{"key":"2025082801510777000_16.2.e249456.5","doi-asserted-by":"crossref","first-page":"309","DOI":"10.1016\/j.ajem.2021.05.030","article-title":"Sedation in mechanically ventilated covid-19 patients: a narrative review for emergency medicine providers","volume":"54","author":"Keswani","year":"2022","journal-title":"Am J Emerg Med"},{"key":"2025082801510777000_16.2.e249456.6","first-page":"260385","article-title":"Propofol infusion syndrome in adults: a clinical update","volume":"2015","author":"Mirrakhimov","year":"2015","journal-title":"Crit Care Res Pract"},{"key":"2025082801510777000_16.2.e249456.7","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1208705"},{"key":"2025082801510777000_16.2.e249456.8","doi-asserted-by":"publisher","DOI":"10.1007\/s40262-018-0672-3"},{"key":"2025082801510777000_16.2.e249456.9","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199507203330303"},{"key":"2025082801510777000_16.2.e249456.10","doi-asserted-by":"publisher","DOI":"10.1592\/phco.20.13.1120.35041"},{"key":"2025082801510777000_16.2.e249456.11","doi-asserted-by":"publisher","DOI":"10.1093\/bjaceaccp\/mkt007"},{"key":"2025082801510777000_16.2.e249456.12","doi-asserted-by":"crossref","first-page":"e441","DOI":"10.1016\/j.bja.2020.08.020","article-title":"Propofol infusion syndrome in severe COVID-19","volume":"125","author":"Lucchetta","year":"2020","journal-title":"Br J Anaesth"},{"key":"2025082801510777000_16.2.e249456.13","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(00)03547-9"},{"key":"2025082801510777000_16.2.e249456.14","doi-asserted-by":"publisher","DOI":"10.1177\/0885066610384195"},{"key":"2025082801510777000_16.2.e249456.15","unstructured":"US Food and Drug Administration . Fact sheet for healthcare providers: emergency use authorization (EUA) of fresenius propoven (propofol) 2% emulsion. 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