Evidence map›Paper›PMID 12904852›Full record

ReviewIntensive care medicine2003

The pathophysiology of propofol infusion syndrome: a simple name for a complex syndrome.

Beatrice Vasile, Frank Rasulo, Andrea Candiani, Nicola Latronico

Abstract readReview
PubMed Publisher
In one paragraph

Review in Intensive care medicine, 2003. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 120 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
120citing papers in PubMed, 3 pooled it
30.7field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

120 citing papers in PubMed, 3 syntheses or guidelines pooled it, 562 citations in OpenAlex.

  1. Pooled it
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  3. Guideline
  4. A Pilot Study of High-Definition Transcranial Direct Current Stimulation in Refractory Status Epilepticus: The SURESTEP Trial.Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics · 2023
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  14. Characterizing the Safety and Efficacy of Propofol in Critically Ill Pediatric Patients.The journal of pediatric pharmacology and therapeutics : JPPT : the official journal of PPAG · 2026
    Article
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  17. Article
  18. CO2, infections, and critical illnesses.Trauma surgery & acute care open · 2025
    Article
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  20. Article

60 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

4 authors at 1 institution in 1 country.

Beatrice VasileInstitute of Anesthesiology-Intensive Care, University of Brescia, Piazzale Ospedali Civili 1, 25125 Brescia, Italy.
Frank Rasulo
Andrea Candiani
Nicola Latronico
University of Brescia · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Propofol infusion syndrome (PRIS) is a rare and often fatal syndrome described in critically ill children undergoing long-term propofol infusion at high doses. Recently several cases have been reported in adults, too. The main features of the syndrome consist of cardiac failure, rhabdomyolysis, severe metabolic acidosis and renal failure. To date 21 paediatric cases and 14 adult cases have been described. These latter were mostly patients with acute neurological illnesses or acute inflammatory diseases complicated by severe infections or even sepsis, and receiving catecholamines and/or steroids in addition to propofol. Central nervous system activation with production of catecholamines and glucocorticoids, and systemic inflammation with cytokine production are priming factors for cardiac and peripheral muscle dysfunction. High-dose propofol, but also supportive treatments with catecholamines and corticosteroids, act as triggering factors. At the subcellular level, propofol impairs free fatty acid utilisation and mitochondrial activity. Imbalance between energy demand and utilisation is a key pathogenetic mechanism, which may lead to cardiac and peripheral muscle necrosis. Propofol infusion syndrome is multifactorial, and propofol, particularly when combined with catecholamines and/or steroids, acts as a triggering factor. The syndrome can be lethal and we suggest caution when using prolonged (>48 h) propofol sedation at doses higher than 5 mg/kg per h, particularly in patients with acute neurological or inflammatory illnesses. In these cases, alternative sedative agents should be considered. If unsuitable, strict monitoring of signs of myocytolysis is advisable.

Indexed as

AdultAnimalsCatecholaminesCentral Nervous SystemCritical IllnessDrug InteractionsDrug Therapy, CombinationHeartHumansHypnotics and SedativesInflammationInfusions, IntravenousModels, AnimalMultiple Organ FailureMuscle, SkeletalPropofolCatecholaminesHypnotics and SedativesPropofolSteroids

Identifiers

PMID12904852
OpenAlexW2031003242

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.