Abstract
Lipid emulsions are increasingly used as an antidote to lipophilic drug intoxications. The dose recommended by the American Society of Regional Anesthesia is used primarily for the treatment of local anesthetic systemic toxicity. There is insufficient information about what the dose of lipid emulsions (LE) should be in other intoxications depending on their severity. To determine the LE dose in a shock or haemodynamic instability in patients with acute exogenous intoxications treated with LE. Forty-nine patients with acute lipophilic drug intoxications were treated with LE in the Clinic of Toxicology at the Naval Hospital in Varna.Statistical analysis was performed using the statistical functions of Excel 2016 and the Statistica 7.0 software package. The percentage of patients receiving a low dose of LE of 0.3 ml/kg (93.87%) was significantly higher than the percentage of patients treated with a medium (2.04%) and a high dose (4.08%) of LF. The high dose of LE of 1.5 ml/kg recommended by the American Society of Regional Anesthesia was administered to two patients (4.08%). In severe intoxications with exotoxic shock, the rate of LE administration varies from 20 ml/h to 40 ml/h. In severe intoxications with cardiotoxic syndrome and haemodynamic instability, LE should be used in the dose as suggested by the American Society of Regional Anesthesia. It is possible to use lower doses of LE in the range of 0.3-0.6 ml/kg in all moderate poisonings administered by continuous intravenous infusion for 12-24-48 hours. No side effects were observed at these doses.
Highlights
Lipid emulsions are increasingly used as an antidote to lipophilic drug intoxications
The etiological distribution of acute drug intoxications includes mainly antidepressants, neuroleptics, and cardiovascular drugs. Overdosing of these drugs can often cause fatal complications despite the timely administered therapy, which makes it necessary that more effective treatments such as the intravenous lipid emulsion (LE) therapy should be introduced into routine practice
The aim of the study was to determine the dosing methods of lipid emulsions (LE) depending on the severity of intoxications and monitoring of adverse effects at different dose regimens in patients with acute exogenous intoxications treated with LE as part of a standard therapy in the Clinic of Toxicology at the Naval Hospital, Varna
Summary
Lipid emulsions are increasingly used as an antidote to lipophilic drug intoxications. Aim: To determine the LE dose in a shock or haemodynamic instability in patients with acute exogenous intoxications treated with LE. The high dose of LE of 1.5 ml/kg recommended by the American Society of Regional Anesthesia was administered to two patients (4.08%). Conclusions: In severe intoxications with cardiotoxic syndrome and haemodynamic instability, LE should be used in the dose as suggested by the American Society of Regional Anesthesia. The etiological distribution of acute drug intoxications includes mainly antidepressants, neuroleptics, and cardiovascular drugs. Overdosing of these drugs can often cause fatal complications despite the timely administered therapy, which makes it necessary that more effective treatments such as the intravenous lipid emulsion (LE) therapy should be introduced into routine practice. Designed to provide essential fatty acids for patients who are unable to eat per os, LE has been used in recent years as an antidote in cases of overdosing with local anesthetics and other lipophilic drugs
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
