Propofol, an intravenously administered, centrally acting sedative/hypnotic, is a popular medication for anesthesia and sedation due to rapid onset, controllability and short recovery time. Prolonged propofol infusions, (>48 h) with elevated doses (>67 mcg/kg/min) may result in a rare but fatal condition known as the Propofol Related Infusion Syndrome (PRIS). This is a case of severe metabolic acidosis and refractory hyperkalemia in a 53 year old female with polytrauma on a continuous propofol infusion that was associated with fatal outcome.

This case presentation describes the management of these complications using a combined open and endovascular approach in a well-equipped hybrid operating theatre, resulting in the patient survival.

No abstract

a b s t r a c tProstaglandin F2a (PGF) treatment is routinely used in the reproductive management of mares to induce luteolysis and allow a subsequent return to estrus. The objective of this retrospective study was to assess the effect of follicle size at the time of administration of cloprostenol on interval to subsequent ovulation. A secondary objective was to determine the incidence of hemorrhagic anovulatory follicle (HAF) formation after PGF administration. Reproductive records of 275 mares monitored over a total of 520 estrous cycles were evaluated. All mares received a single intramuscular dose of 250 mg of the synthetic PGF analog cloprostenol sodium between days 5 and 12 after ovulation. The average interval from PGF to ovulation was 8.4 AE 2.5 days. The interval from PGF administration to subsequent ovulation was inversely proportional to the diameter of the largest follicle at the time of treatment. Administration of cloprostenol to mares with a large (!35 mm in diameter) diestrous follicle resulted in one of three outcomesdovulation within 48 hours (13.4%) with variable uterine edema, ovulation after 48 hours usually accompanied by the presence of uterine edema (73.1%), or regression without ovulation followed by emergence and eventual ovulation of a new dominant follicle (13.4%). There was no effect of mare age or season on interval from PGF to ovulation. The overall incidence of HAF development after PGF administration in this study was low (2.5%).