Severe Neuroexcitatory Reaction: A Rare and Underrecognized Life-Threatening Complication of Propofol-Induced Anesthesia.

We describe a case of severe neuroexcitatory reaction with hyperthermia after administration of propofol in a 43-year-old patient suspected of a relapse of sarcoidosis who underwent bronchoscopy. This resulted in a lengthy stay in intensive care and long-term neuropsychological impairment. A review of the literature shows that severe neuroexcitatory symptoms (seizure-like phenomena, abnormal hypertonic, and/or jerky movements) occur rarely after propofol administration and may be life-threatening.

[The refeeding syndrome in the elderly population : from hospital to home].

The refeeding syndrome (RS) is a consequence of passing from a catabolic state to an anabolic state triggered by renutrition that is followed by a prolonged period of fasting. Often under-diagnosed in the context of malnutrition or multimorbid patients, RS presents itself through nonspecific symptoms (oedema and tachycardia) that can rapidly progress in the first 72 hours into life threatening states. The internationally recognized NICE guidelines estimate the risk of RS and are based on BMI, weight loss and electrolyte levels.

[Disease related malnutrition: oral and enteral artificial nutrition].

Disease related malnutrition has numerous financial and medical consequences and requires to be treated by a nutritional team. Sick patients will frequently need an artificial oral or enteral nutritional support. Prescribing oral nutritional supplements (ONS) with a real indication has to be associated to a bundle of measures to enhance compliance.