A 45-year-old man with multiple abdominal gunshot wounds is intubated in the ICU and has been receiving continuous infusion of propofol and fentanyl for 3 days. His morning labs reveal a potassium count of 6.3 mEq/L, bicarbonate of 16 mEq/L, and the patient had 3 episodes of unsustained ventricular tachycardia overnight. What is your next step in management?
A. Administer calcium gluconate, insulin,and β-blockers for his hyperkalemia.
B. Opt for cardioversion.
C. Discontinue propofol.
D. Resuscitate with fluids to increase bicarbonate.
E. Opt for hemodialysis.
答案解析：
丙泊酚输注综合征是一种罕见但严重且潜在致死性不良反应，通常在输注速率 > 83 μg/kg/min超过48小时时观察到，死亡率高达85%。该综合征以心律失常、心力衰竭、代谢性酸中毒、高钾血症和横纹肌溶解为特征。高危患者包括接受高剂量药物的患者、有高甘油三酯血症病史的患者和同时接受肠外脂质营养的患者。治疗包括立即停止丙泊酚输注，纠正血流动力学和代谢异常。
正确答案：C
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