Cassandra Wasson* and Albert Kelly
51-year-old male with adrenomyeloneuropathy required a video-assisted thorascopic surgery (VATS) for left parapneumonic empyema, likely from recurrent micro-aspirations. General anesthesia and surgery were uneventful. The patient met extubation criteria and was transferred to the intensive care unit (ICU). He required re-intubation post-operatively for hypoxemia and was started on total parenteral nutrition (TPN) and a propofol infusion. He continued to weaken post-operatively, received a percutaneous gastrostomy tube and a tracheostomy, and was transferred to a long-term acute care facility. A poor understanding of the pharmakokinetics of propofol and TPN on adrenomyeloneuropathy may have caused the rapid progression of this rare disease.
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