{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T01:17:55Z","timestamp":1783732675606,"version":"3.55.0"},"reference-count":55,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T00:00:00Z","timestamp":1768953600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Continuous anesthetics are often required for the management of refractory status epilepticus. While essential to achieving seizure control, these agents carry significant adverse effects. In particular, propofol may induce hypotension, respiratory depression, metabolic acidosis, or pancreatitis, with the most feared complication being propofol infusion syndrome (PRIS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      The primary objective was to investigate the biological effects of propofol in patients with status epilepticus admitted to the neurointensive care unit of Piti\u00e9-Salp\u00eatri\u00e8re Hospital (Paris, France) for at least 48\u202fh between September 2015 and October 2024. Twenty biological parameters reflecting acid\u2013base balance, organ function, lipid metabolism, and inflammation were analyzed. To capture delayed effects, biological tests from day\n                      <jats:italic>t\u202f+\u202f1<\/jats:italic>\n                      were used to assess propofol exposure on day\n                      <jats:italic>t<\/jats:italic>\n                      . A linear mixed-effects model was applied, with each marker as the dependent variable, propofol exposure (including patients who did not receive propofol as the reference group) or dose of propofol as the fixed-effect predictor, and patient as a random effect. A secondary objective was to determine the incidence of PRIS in this tertiary referral center for the management of refractory and super-refractory status epilepticus.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 235 patients were enrolled, of whom 51% received propofol for at least 1\u202fday. We collected biological data over 2,407 patient-days, including 1,086 (45%) under propofol infusion. Propofol use was associated with lipid dysregulation, characterized by increased triglycerides, decreased LDL-cholesterol and HDL-cholesterol, along with impaired renal function, and mild acute respiratory acidosis, reflected by elevated pCO\n                      <jats:sub>2<\/jats:sub>\n                      , and reduced pH and phosphate levels. Propofol exposure was also associated with a pro-inflammatory profile, characterized by elevated CRP, procalcitonin, leukocyte counts, and an altered neutrophil-to-lymphocyte ratio, independent of the patient\u2019s clinical inflammatory status. Over the past 10\u202fyears, only four cases of likely or most likely PRIS cases were identified.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Prolonged propofol infusions warrant routine monitoring of specific biological markers. Our study identifies key parameters to follow and confirms that PRIS remains rare in specialized centers where patients are closely monitored and risk factors are carefully considered.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fneur.2025.1753979","type":"journal-article","created":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T05:35:37Z","timestamp":1768973737000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Propofol-related biological alterations and incidence of propofol infusion syndrome in status epilepticus: a 10-year cohort study"],"prefix":"10.3389","volume":"16","author":[{"given":"Chanez","family":"Djahel","sequence":"first","affiliation":[{"name":"AP-HP.Sorbonne Universit\u00e9, Piti\u00e9-Salp\u00eatri\u00e8re-Charles Foix University Hospital, Department of Metabolic Biochemistry, DMU BioGeMH","place":["Paris, France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cl\u00e9mence","family":"Marois","sequence":"additional","affiliation":[{"name":"AP-HP.Sorbonne Universit\u00e9, H\u00f4pital de la Piti\u00e9-Salp\u00eatri\u00e8re, Neuro-Intensive Care Unit","place":["Paris, France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L\u00e9a","family":"Cosme","sequence":"additional","affiliation":[{"name":"AP-HP, H\u00f4pital de la Piti\u00e9-Salp\u00eatri\u00e8re, Sorbonne Universit\u00e9, Epilepsy Unit and Department of Clinical Neurophysiology, ERN-Epicare","place":["Paris, France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zineb","family":"Hayatou","sequence":"additional","affiliation":[{"name":"Sorbonne Universit\u00e9, Institut du Cerveau - Paris Brain Institute - ICM, Inserm, CNRS, AP-HP, H\u00f4pital de la Piti\u00e9 Salp\u00eatri\u00e8re","place":["Paris, France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nesrine","family":"Braham Ghedira","sequence":"additional","affiliation":[{"name":"AP-HP.Sorbonne Universit\u00e9, Piti\u00e9-Salp\u00eatri\u00e8re-Charles Foix University Hospital, Department of Metabolic Biochemistry, DMU BioGeMH","place":["Paris, France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Quentin","family":"Calonge","sequence":"additional","affiliation":[{"name":"AP-HP, H\u00f4pital de la Piti\u00e9-Salp\u00eatri\u00e8re, Sorbonne Universit\u00e9, Epilepsy Unit and Department of Clinical Neurophysiology, ERN-Epicare","place":["Paris, France"]},{"name":"Sorbonne Universit\u00e9, Institut du Cerveau - Paris Brain Institute - ICM, Inserm, CNRS, AP-HP, H\u00f4pital de la Piti\u00e9 Salp\u00eatri\u00e8re","place":["Paris, France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincent","family":"Navarro","sequence":"additional","affiliation":[{"name":"AP-HP, H\u00f4pital de la Piti\u00e9-Salp\u00eatri\u00e8re, Sorbonne Universit\u00e9, Epilepsy Unit and Department of Clinical Neurophysiology, ERN-Epicare","place":["Paris, France"]},{"name":"Sorbonne Universit\u00e9, Institut du Cerveau - Paris Brain Institute - ICM, Inserm, CNRS, AP-HP, H\u00f4pital de la Piti\u00e9 Salp\u00eatri\u00e8re","place":["Paris, France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam","family":"Celier","sequence":"additional","affiliation":[{"name":"AP-HP.Sorbonne Universit\u00e9, H\u00f4pital de la Piti\u00e9-Salp\u00eatri\u00e8re, Neuro-Intensive Care Unit","place":["Paris, France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dominique","family":"Bonnefont-Rousselot","sequence":"additional","affiliation":[{"name":"AP-HP.Sorbonne Universit\u00e9, Piti\u00e9-Salp\u00eatri\u00e8re-Charles Foix University Hospital, Department of Metabolic Biochemistry, DMU BioGeMH","place":["Paris, France"]},{"name":"Universit\u00e9 Paris Cit\u00e9, UTCBS, CNRS, INSERM","place":["Paris, France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Randa","family":"Bittar","sequence":"additional","affiliation":[{"name":"AP-HP.Sorbonne Universit\u00e9, Piti\u00e9-Salp\u00eatri\u00e8re-Charles Foix University Hospital, Department of Metabolic Biochemistry, DMU BioGeMH","place":["Paris, France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophie","family":"Demeret","sequence":"additional","affiliation":[{"name":"AP-HP.Sorbonne Universit\u00e9, H\u00f4pital de la Piti\u00e9-Salp\u00eatri\u00e8re, Neuro-Intensive Care Unit","place":["Paris, France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aur\u00e9lie","family":"Hanin","sequence":"additional","affiliation":[{"name":"AP-HP.Sorbonne Universit\u00e9, Piti\u00e9-Salp\u00eatri\u00e8re-Charles Foix University Hospital, Department of Metabolic Biochemistry, DMU BioGeMH","place":["Paris, France"]},{"name":"Sorbonne Universit\u00e9, Institut du Cerveau - Paris Brain Institute - ICM, Inserm, CNRS, AP-HP, H\u00f4pital de la Piti\u00e9 Salp\u00eatri\u00e8re","place":["Paris, France"]},{"name":"Universit\u00e9 Paris Cit\u00e9, Facult\u00e9 de Pharmacie","place":["Paris, France"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,1,21]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"1515","DOI":"10.1111\/epi.13121","article-title":"A definition and classification of status epilepticus--report of the ILAE task force on classification of status epilepticus","volume":"56","author":"Trinka","year":"2015","journal-title":"Epilepsia"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1111\/epi.18627","article-title":"Incidence, mortality, and management of status epilepticus from 2012 to 2022: an 11-year nationwide study","author":"Calonge","year":"2025","journal-title":"Epilepsia"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1097\/WNP.0000000000000806","article-title":"American clinical neurophysiology society\u2019s standardized critical care EEG terminology: 2021 version","volume":"38","author":"Hirsch","year":"2021","journal-title":"J Clin Neurophysiol"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"158","DOI":"10.1016\/j.yebeh.2015.05.007","article-title":"Salzburg consensus criteria for non-convulsive status epilepticus--approach to clinical application","volume":"49","author":"Leitinger","year":"2015","journal-title":"Epilepsy Behav"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1007\/s00134-023-07263-w","article-title":"Status epilepticus in the ICU","volume":"50","author":"Rossetti","year":"2024","journal-title":"Intensive Care Med"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"559","DOI":"10.1212\/CON.0000000000001103","article-title":"Management of Status Epilepticus, refractory status epilepticus, and super-refractory status epilepticus","volume":"28","author":"Trinka","year":"2022","journal-title":"Continuum (Minneap Minn)"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"78","DOI":"10.1111\/anae.15606","article-title":"Management of status epilepticus: a narrative review","volume":"77","author":"Migdady","year":"2022","journal-title":"Anaesthesia"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"317","DOI":"10.1186\/s13054-018-2235-2","article-title":"Impact of timing of continuous intravenous anesthetic drug treatment on outcome in refractory status epilepticus","volume":"22","author":"Mad\u017ear","year":"2018","journal-title":"Crit Care"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"1493","DOI":"10.1111\/epi.17614","article-title":"Early timing of anesthesia in status epilepticus is associated with complete recovery: a 7-year retrospective two-center study","volume":"64","author":"De Stefano","year":"2023","journal-title":"Epilepsia"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"e564","DOI":"10.1212\/WNL.0000000000012292","article-title":"Safety and efficacy of coma induction following first-line treatment in status epilepticus: a 2-Center study","volume":"97","author":"De Stefano","year":"2021","journal-title":"Neurology"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"100146","DOI":"10.1016\/j.jcadva.2025.100146","article-title":"Anesthetic agents in the management of status epilepticus: current perspectives","volume":"2","author":"Kutum","year":"2025","journal-title":"JCA Adv"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"e1191","DOI":"10.1212\/WNL.0000000000200818","article-title":"Management of Refractory Status Epilepticus: an international cohort study (MORSE CODe) analysis of patients managed in the ICU","volume":"99","author":"Chiu","year":"2022","journal-title":"Neurology"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"55","DOI":"10.1186\/s12883-019-1281-y","article-title":"Systematic review and meta-analysis of propofol versus barbiturates for controlling refractory status epilepticus","volume":"19","author":"Zhang","year":"2019","journal-title":"BMC Neurol"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"656","DOI":"10.1212\/WNL.0000000000000009","article-title":"Anesthetic drugs in status epilepticus: risk or rescue? 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