Propofol Related Infusion Syndrome (PRIS)

Propofol Related Infusion Syndrome (PRIS)➧ It is a rare syndrome that affects patients undergoing long-term treatment with high doses of the anesthetic and sedative drug propofol.  ➧ It is associated with high doses and long-term use of propofol (>4 mg/kg/hr for more than 24 hours). It occurs more commonly in children, and critically ill patients receiving...

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Central Anticholinergic Syndrome

Central Anticholinergic Syndrome ➧ Many of the drugs used in anesthesia and intensive care may cause blockage of the central cholinergic neurotransmission. ➧ Acetylcholine is of significance in the modulation of the interaction among most other central transmitters. Causes: 1- Overdose of anticholinergic drugs: e.g. Atropine, scopolamine, glycopyrrolate 2- Overdose of drugs that possess an anticholinergic activity: e.g....

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Fospropofol disodium (Lusedra®)

Fospropofol disodium (Lusedra®)Chemistry: ➧ The chemical nature of propofol is 2,6-diisopropyl phenol. When a phosphate group is added to this molecule, it results in the formation of water-soluble propofol that does not contain lipids, egg products, or preservatives, thereby eliminating the allergic, bacterial infections and hyperlipidemic concerns associated with propofol.  ➧...

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Magnesium Sulphate (MgSO₄)

Magnesium Sulphate (MgSO₄)Magnesium Physiology: ➧ Magnesium is the fourth most abundant cation in the body and is the second most abundant intracellular cation in the human body (potassium being the first). ➧ It has numerous physiological activities including activation of enzymes involved in energy metabolism, protein synthesis, regulation of vasomotor tone, neurotransmission,...

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Sugammadex (Bridion®)

Cyclodextrins ➧ The starting point for encapsulating agents that used since 1953 as solubilizing agents and form low-affinity complexes with lipophilic drugs. ➧ γ-cyclodextrin: 8 sugar molecules forming a rigid ring with a central lipophilic cavity. ➧ Very water-soluble, not metabolized, renally excreted. Sugammadex (Bridion®) ➧ Sugammadex is a modified...

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Traumatic Complications of TI

Traumatic Complications of TI ➧ Despite the frequent use of tracheal intubation (TI) for both short-term events like surgery or for long-term ventilatory support, traumatic complications from TI still occur. ➧ Both the upper and lower airways are at risk of injury. The upper airway includes the naso- and oro-pharynx and extends to the level of the vocal cords. The...

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Complications while ETT in place

Complications while ETT is in place A) Obstruction of the endotracheal tube (ETT): Causes: 1-Accumulation of secretions in the tube  2-Kinking of the tube.B) Misplacement or migration of the ETT: ➧ A common complication and right mainstem intubation has been associated with increased mortality in critically ill patients.  ➧ Traditional methods of assuring proper tube position include:  -Observing bilateral...

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