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Hypertriglyceridaemia Propofol Sedation — FRCA Final MCQ

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ModerateGeneral AnaesthesiaHypertriglyceridaemia Propofol SedationFRCA Final

An 80 kg ICU patient has propofol at 4 mg/kg/h for 4 days. Triglycerides 5.8 mmol/L. What is the most appropriate next step?

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Correct answer: E — Switch to an alternative sedative agent

Hypertriglyceridaemia >5 mmol/L during prolonged propofol is a warning sign of PRIS. At 4 mg/kg/h for 4 days, this exceeds safe limits (>4 mg/kg/h or >48h). Switch immediately to midazolam or dexmedetomidine. Monitor for metabolic acidosis, rhabdomyolysis, cardiac failure, hyperkalaemia.

Reference: ICS – 2022 – Guidelines for sedation of the critically ill patient