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CRITICAL CARE AND TRAUMA

Clinical Management of Cardiogenic Shock Associated with Prolonged Propofol Infusion

Department of Anesthesia (Cardiothoracic Section), Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania

Address correspondence and reprint requests to John G. Augoustides, MD, Assistant Professor of Anesthesia, Department of Anesthesia (Cardiothoracic Section), Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104–4283 USA. Address email to yiandoc{at}hotmail.com

This case report details the development of cardiogenic shock after craniotomy in a patient sedated with a propofol infusion. The patient survived with the assistance of extracorporeal membrane oxygenation. A literature review summarizes the syndrome of cardiogenic shock associated with prolonged propofol infusion. This is the first report of survival in this syndrome resulting from mechanical circulatory support.

IMPLICATIONS: This case report details survival of a patient who developed postoperative cardiogenic shock associated with a prolonged propofol infusion. The pivotal role of mechanical circulatory support is emphasized. The management of circulatory collapse in a patient sedated with propofol should include prompt discontinuation of propofol and early institution of mechanical circulatory support.

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