Etio: High-dose propofol (>4-5 mg/kg/hr) for >48 hours Pathophys: Propofol impairing mitochondrial function and fatty acid breakdown for energy, leading to: - anion gap metabolic acidosis - rhabdomyolysis - renal failure - cardiac failure (acute bradycardia, hypotension) Dx: - ↗ TG lvl Tx: - dc propofol