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Review article: Intravenous lipid emulsion as antidote: A summary of published human experience.
MedLine Citation:
PMID:  21489160     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Intravenous lipid emulsion (ILE) has been demonstrated to be effective in amelioration of cardiovascular and central nervous system sequelae of local-anaesthetic and non-local-anaesthetic drug toxicity in animal models. Sequestration of lipophilic toxins to an expanded plasma lipid phase is credited as the predominant beneficial mechanism of action of ILE. Systematic review of published human experience is however lacking. We determined to report a comprehensive literature search of all human reports of ILE application in drug poisoning. Forty-two cases of ILE use (19 local-anaesthetic, 23 non-local-anaesthetic) were identified, with anecdotal reports of successful resuscitation from cardiovascular collapse and central nervous system depression associated with ILE administration in lipophilic toxin overdose. Although significant heterogeneity was observed in both agents of intoxication, and reported outcomes; case report data suggest a possible benefit of ILE in potentially life-threatening cardio-toxicity from bupivacaine, mepivacaine, ropivacaine, haloperidol, tricyclic antidepressants, lipophilic beta blockers and calcium channel blockers. Further controlled study and systematic evaluation of human cases is required to define the clinical role of ILE in acute poisonings.
Authors:
Grant Cave; Martyn Harvey; Andis Graudins
Publication Detail:
Type:  Journal Article     Date:  2011-04-07
Journal Detail:
Title:  Emergency medicine Australasia : EMA     Volume:  23     ISSN:  1742-6723     ISO Abbreviation:  Emerg Med Australas     Publication Date:  2011 Apr 
Date Detail:
Created Date:  2011-04-14     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101199824     Medline TA:  Emerg Med Australas     Country:  Australia    
Other Details:
Languages:  eng     Pagination:  123-41     Citation Subset:  IM    
Copyright Information:
© 2011 The Authors. EMA © 2011 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.
Affiliation:
Hutt Hospital, Lower Hutt University of Otago, Wellington School of Medicine and Health Sciences, Wellington Emergency Department, Waikato Hospital, Hamilton University of Auckland, Waikato Campus, Auckland, New Zealand Tamworth Rural Referral Hospital, Tamworth, New South Wales Department of Medicine, Southern Clinical School, Monash University Southern Health, Monash Medical Centre, Clayton, Victoria, Australia.
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