Severe heart failure and rhabdomyolysis associated with propofol infusion in a burn patient

• Published in: Journal of burn care & research Vol. 35; no. 5; pp. e364 - e367
• Main Authors: Linko, Rita, Laukkanen, Annika, Koljonen, Virve, Rapola, J, Varpula, Tero
• Format: Journal Article
• Language: English
• Published: England 01-09-2014
• Subjects: Acute Kidney Injury - chemically induced; Acute Kidney Injury - therapy; Anesthetics, Intravenous - adverse effects; Burns - therapy; Heart Failure - chemically induced; Heart Failure - therapy; Humans; Male; Propofol - adverse effects; Renal Replacement Therapy; Rhabdomyolysis - chemically induced; Rhabdomyolysis - therapy; Young Adult
• ISSN: 1559-047X; 1559-0488
• DOI: 10.1097/BCR.0000000000000053

The authors report a favorable outcome in an adult burn patient, who developed severe propofol-related infusion syndrome presenting with rhabdomyolysis, acute kidney injury, and right-sided heart failure after a low-dose propofol infusion. Other possible causes for late-onset rhabdomyolysis after burn trauma were ruled out by extensive differential diagnostics. The most distinctive abnormal finding was a Brugada-type ST-segment elevation, reported previously associating with imminent death. The patient survived because of cessation of propofol infusion and continuous renal replacement therapy. ECG recording is important in early detection of propofol-related infusion syndrome. ST elevations in the ECG should lead to the immediate discontinuation of propofol.