American Board of Surgery Qualifying Exam (ABS QE) Practice Test

Which of the following is a consequence of propofol infusion syndrome?

1. Respiratory failure

2. Cerebral edema

3. Lactic acidosis

4. Anaphylactic reaction

The correct answer is: Lactic acidosis

Propofol infusion syndrome is a rare but serious complication associated with the prolonged administration of high doses of propofol, particularly in critically ill patients. The syndrome is characterized by a distinct metabolic derangement that includes lactic acidosis, which is a key consequence. Lactic acidosis occurs due to the impairment of oxidative metabolism, leading to an accumulation of lactic acid in the blood. This is thought to result from mitochondrial dysfunction and the inhibition of beta-oxidation of fatty acids. Affected patients may develop severe metabolic acidosis, which can lead to systemic complications, organ dysfunction, and, in severe cases, even death. While other serious complications like respiratory failure or cerebral edema can occur in critically ill patients receiving various sedatives and analgesics, they are not specific consequences of propofol infusion syndrome. An anaphylactic reaction may occur with any medication but is not a feature associated with propofol infusion syndrome itself. Understanding the unique profile of propofol and its potential for causing metabolic disturbances is crucial for managing patients receiving this sedative agent, especially in an intensive care setting.