A severely ill patient was maintained on an infusional anaesthetic agent. On the 2ndday he started detiorating. The probable culprit may be –

Information in this question are - Patient is critically ill       Detioration on 2nd day. These suggest the diagnosis of propofol infusion syndrome which is a rare but lethal syndrome. It is associated with infusion of propofol at 4 mg/kg/hr or more for 48 hours or longer. It occurs in children or critically ill patients. It is characterized by acute refractory bradycardia leading to asystole, metabolic acidosis, rhabdomyolysis, hyperlipidemia and enlarged fatty liver.