Propofol Infusion Syndrome: Recognition, Risk and Prevention (A Condensed Review)

Background. Propofol infusion syndrome (PRIS) is a rare but potentially fatal complication of propofol administration, reported most often during prolonged or high-dose infusion in critically ill patients. Aim. To summarise current evidence on the risk factors, pathogenesis, recognition, treatment and prevention of PRIS for clinicians who use propofol for sedation. Materials and methods. Narrative review of publications issued between January 1990 and December 2025 and indexed in PubMed/MEDLINE, Scopus, Google Scholar and eLIBRARY.ru, supplemented by screening of reference lists. Conclusion. Mitochondrial dysfunction and impaired energy metabolism are considered important mechanisms of this multifactorial complication. Infusion rates above 4 mg/kg/h and durations beyond 48 hours are the most consistently reported risk markers, but PRIS has also been reported below these limits, so no threshold excludes it. Management requires prompt discontinuation of propofol when PRIS is suspected, together with supportive treatment of organ dysfunction.