| Intravenous lipid emulsion as antidote beyond local anesthetic toxicity: a systematic review. | |
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MedLine Citation:
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PMID: 19845549 Owner: NLM Status: In-Process |
Abstract/OtherAbstract:
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OBJECTIVES: The objective was to asses the efficacy of lipid emulsion as antidotal therapy outside the accepted setting of local anesthetic toxicity. METHODS: Literature was accessed through PubMed, OVID (1966-February 2009), and EMBASE (1947-February 2009) using the search terms "intravenous" AND ["fat emulsion" OR "lipid emulsion" OR "Intralipid"] AND ["toxicity" OR "resuscitation" OR "rescue" OR "arrest" OR "antidote"]. Additional author and conference publication searches were undertaken. Publications describing the use of lipid emulsion as antidotal treatment in animals or humans were included. RESULTS: Fourteen animal studies, one human study, and four case reports were identified. In animal models, intravenous lipid emulsion (ILE) has resulted in amelioration of toxicity associated with cyclic antidepressants, verapamil, propranolol, and thiopentone. Administration in human cases has resulted in successful resuscitation from combined bupropion/lamotrigine-induced cardiac arrest, reversal of sertraline/quetiapine-induced coma, and amelioration of verapamil- and beta blocker-induced shock. CONCLUSIONS: Management of overdose with highly lipophilic cardiotoxic medications should proceed in accord with established antidotal guidelines and early poisons center consultation. Data from animal experiments and human cases are limited, but suggestive that ILE may be helpful in potentially lethal cardiotoxicity or developed cardiac arrest attributable to such agents. Use of lipid emulsion as antidote remains a nascent field warranting further preclinical study and systematic reporting of human cases of use. |
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Authors:
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Grant Cave; Martyn Harvey |
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Publication Detail:
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Type: Journal Article; Review |
Journal Detail:
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Title: Academic emergency medicine : official journal of the Society for Academic Emergency Medicine Volume: 16 ISSN: 1553-2712 ISO Abbreviation: Acad Emerg Med Publication Date: 2009 Sep |
Date Detail:
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Created Date: 2009-10-22 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9418450 Medline TA: Acad Emerg Med Country: United States |
Other Details:
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Languages: eng Pagination: 815-24 Citation Subset: IM |
Copyright Information:
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(c) 2009 by the Society for Academic Emergency Medicine |
Affiliation:
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Hutt Hospital, Lower Hutt, New Zealand. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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