<unk>  =<unk> 
Refractory bradycardia and cardiovascular collapse
Poorly understood mechanism
Risk factors
High doses of (> 4mg/kg/hr or 67 mcg/kg/min)
Long duration (> 48 hrs)
Younger age <unk>  first recognized in pediatric population)
Critical illness
Malnutrition
Liver disease
Carnitine deficiency
Mitochondrial disease
Catecholamine, vasopressor<unk> 
Corticosteroid<unk> 
High doses of (> 4mg/kg/hr or 67 mcg/kg/min)
Long duration (> 48 hrs)
Younger age <unk>  first recognized in pediatric population)
Critical illness
Malnutrition
Liver disease
Carnitine deficiency
Mitochondrial disease
Catecholamine, vasopressor<unk> 
Corticosteroid<unk>
Propofol infusion syndrome
Neurogenic shock
Spinal shock
Cardiogenic shock
Hemorrhagic shock
Undifferentiated shock 
Undifferentiated shock
Heat stroke