Document Detail

Lipid resuscitation for local anesthetic toxicity: is it really lifesaving?
MedLine Citation:
PMID:  19581805     Owner:  NLM     Status:  MEDLINE    
PURPOSE OF REVIEW: Laboratory studies and clinical reports have led to the acceptance of lipid emulsion as an effective treatment of local anesthetic-induced cardiac arrest. This review discusses subsequent clinical reports, relevant laboratory studies and topics for further research. RECENT FINDINGS: Case reports have confirmed the efficacy of lipid resuscitation for local anesthetic systemic toxicity. Furthermore, lipid emulsion has been used with apparent success early in the spectrum of local anesthetic systemic toxicity to preempt cardiac arrest. The role of lipid emulsion has expanded to treatment of cardiac toxicity due to other lipophilic drugs. This appears to have an acceptable safety profile, although elevated amylase has been reported. Laboratory investigations in animals suggest that concomitant hypoxemia hinders resuscitation attempts, and that epinephrine and vasopressin are more likely to be associated with poor outcomes than lipid. SUMMARY: Lipid emulsion infusion appears to be an effective treatment for cardiac toxicity induced by lipophilic medications. Given the difficulties of performing clinical trials, further laboratory investigation and clinical correlation are needed to better define its role in resuscitation.
Ulana Leskiw; Guy L Weinberg
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Current opinion in anaesthesiology     Volume:  22     ISSN:  1473-6500     ISO Abbreviation:  Curr Opin Anaesthesiol     Publication Date:  2009 Oct 
Date Detail:
Created Date:  2009-09-02     Completed Date:  2010-01-19     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8813436     Medline TA:  Curr Opin Anaesthesiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  667-71     Citation Subset:  IM    
University of Illinois at Chicago College of Medicine, Illinois 60612, USA.
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MeSH Terms
Anesthetics, Local / poisoning*
Blood Gas Analysis
Fat Emulsions, Intravenous / administration & dosage*,  adverse effects*
Guidelines as Topic
Heart Arrest* / chemically induced,  therapy
Reg. No./Substance:
0/Anesthetics, Local; 0/Fat Emulsions, Intravenous

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