Use Of Intralipid Research Articles

KALİTELİ EMBRİYO TRANSFERİNE RAĞMEN BAŞARISIZ IVF SİKLUSU OLAN KADINLARDA İN VİTRO FERTİLİZASYON (IVF) TEDAVİSİ BOYUNCA İV LİPİD (SMOFLIPID®) KULLANIMININ ETKİSİ: VAKA KONTROL ÇALIŞMASI

Objectives: Since recurrent implantation failure (RIF) is a challenging fact, effects of different therapeutic immunomodulatory agents are being investigated to overcome this problem. This study aimed to evaluate the effect of intralipid on pregnancy outcomes of IVF patients with RIF.
 Methods: 116 of the participants who received only the short antagonist protocol allocated in the control group, whereas 106 patients were in intralipid group by additionally receiving intravenous lipid (SMOFlipid®). Intralipid was given on the day of embryo transfer, on the day of positive pregnancy test and continued weekly until the tenth week of pregnancy. Implantation rate, biochemical pregnancy rate, clinical pregnancy rate and live birth rate were evaluated.
 Results: The positive pregnancy test, clinical pregnancy rate and live birth rate were statistically significantly higher (p0.05).
 Conclusions: This study revealed that intralipid therapy has better pregnancy outcomes in patients with RIF compared to patients undergo standard IVF protocol only. Further prospective studies are needed to suggest the routine use of intralipid in patients with RIF.

Unraveling the role of Intralipid in suppressing off-target delivery and augmenting the therapeutic effects of anticancer nanomedicines

Intralipid, a clinically used lipid emulsion, was reportedly utilized as one strategy to suppress off-target delivery of anticancer nanomedicines; Intralipid also effectively improved drug delivery to tumors and produced better therapeutic effects. However, the mechanisms involved—the why and how—in Intralipid's facilitation of delivery of nanomedicines to tumors have not yet been reported in detail. In this study, we investigated Intralipid and discovered the beneficial effects of Intralipid pretreatment when using three anticancer nanomedicines, including the clinically approved drug doxorubicin (Doxil). Intralipid pretreatment induced a 40% reduction in liver uptake of a polymeric nanoprobe used in photodynamic therapy as well as a 1.5-fold-increased nanomedicine accumulation in tumors. This increased accumulation consequently led to significantly better therapeutic effects, and this finding was validated by using Doxil. As an interesting result, Intralipid pretreatment significantly prolonged the plasma half-life of nanomedicines in normal healthy mice but not in tumor-bearing mice, which suggests that tumors become an alternative route of nanomedicine delivery when liver delivery is suppressed. Also, we found markedly increased tumor blood flow, as measured by fluorescence angiography, and significantly lower blood viscosity after Intralipid pretreatment. All our results together indicate that Intralipid treatment not only suppressed off-target nanomedicine delivery by the reticuloendothelial system, but more important, it enhanced nanomedicine delivery to tumors by improving tumor blood flow, which is key to satisfactory drug delivery via the enhanced permeability and retention effect. Significantly better therapeutic outcomes were thus achieved by the strategy of combining utilization of nanomedicines and Intralipid pretreatment. Statement of significanceOff-target delivery to organs such as the liver and obstructed tumor blood flow as is often seen in advanced cancers are major barriers to the therapeutic efficacy of anticancer nanomedicines. Intralipid has been shown effective for suppressing nanomedicine accumulation in the liver, resulting in improved anticancer effects. Unraveling the mechanisms involved in this process will be greatly helpful for the clinical application of anticancer nanomedicines. We reported here that Intralipid could also significantly increase tumor delivery of nanomedicine, which is beneficial for improving tumor blood flow and lowering blood viscosity. To our knowledge, this is the first study to investigate the role of Intralipid in this regard. This knowledge provides a solid rationale for the use of Intralipid in combination with anticancer nanomedicines.

Intralipid-Based Phantoms for the Development of New Optical Diagnostic Techniques

Intralipid is a material widely employed for the preparation of phantoms for optical imaging and biophotonics applications in medical field. The development of new optical diagnostic equipment in these fields requires the use of well-designed phantoms with optical properties (including scattering and absorption) mimicking those of biological tissues in all the pre-clinical stages of investigations. For this reason, great research effort has been devoted to optically characterize Intralipid and at preparing optimal phantoms. In this short review, we summarize the principal physico-chemical characteristics of Intralipid and the main contributions in the assessment of its scattering and absorption properties. In addition, the most largely used Intralipid-based homogeneous and non-homogeneous phantoms are discussed. Even though other materials are available for the preparation of phantoms, the use of Intralipid still offers an inexpensive and easy-to-use method for preparing phantoms with finely tuned optical properties.

The Use of Intralipid® 20% Solution to Reverse the Anesthetic Effect of Local Anesthetics: a Proof of Concept Study in Volunteers

The Use of Intralipid® 20% Solution to Reverse the Anesthetic Effect of Local Anesthetics: a Proof of Concept Study in Volunteers

Use of intralipid in the management of recurrent implantation failure: An overview

Recurrent embryo implantation failure is a disorder with potentially dreadful physiological and psychological manifestations for those who are affected. Embryo implantation and formation of a functional placenta are processes that require a plethora of regulatory mechanisms involving both maternal and embryonic cells. In the ensuing overview, an attempt is made to understand (1) the pathophysiology of recurrent unexplained implantation failure (2) the available evidence for the two popular treatment modalities, i.e., intravenous immune globulin and intralipid, (3) the limitation of current available data, (4) the pathophysiology and immunomodulatory treatment options for recurrent implantation failure to address the pathological, psychological, and financial distress, and associated impact on couple's quality of life.

Innovative use of Intralipid in Critical Care Setting

Innovative use of Intralipid in Critical Care Setting

Intralipid® attenuates acute cardiac allograft rejection in relation to promoting CD4+CD25+Foxp3+ regulatory T-cells and inhibiting toll-like receptor 4 expression

Clinically available agents that promote the suppression of inflammatory processes with minimal adverse effects are highly desired. An FDA-approved nutrition supplement, Intralipid®, has shown its immunomodulatory potential. However, its influence on organ transplant rejection has not been tested. Here, we have investigated whether Intralipid® affect allograft outcome in a fully major histocompatibility complex (MHC)-mismatched rat model of heterotopic working-heart transplantation. Recipients were treated intravenously with Intralipid® (1.5g/kg, clinical dosage) or saline (untreated control) on post-transplantation days (PODs) 1, 3, and 6. Treatment with Intralipid® results in a significant prolongation of median graft survival from 7 days to 12 days. On POD 7, while the allografts from our untreated (i.e., control) group exhibit severe rejection, the allografts from Intralipid®-treated group show milder rejection demonstrating preserved myocardium integrity and decreasing infiltration of inflammatory cells (ED1+ and CD3+ cells). Flow cytometry analysis reveals a marked increase of CD4+CD25+Foxp3+ regulatory T-cells (Tregs) in the peripheral blood of Intralipid®-treated recipients beginning on POD 3 (7.0% vs. 14.4%, untreated vs. Intralipid®-treated). Intralipid® treatment also promotes Tregs in the spleens and allograft hearts. Toll-like receptor 4 expression is markedly suppressed in the Intralipid®-treated allografts. Our results suggest a new use of Intralipid® to modulate immune responses in the setting of heart transplantation. This study could stimulate further mechanistic as well as treatment studies leading to the clinical application of Intralipid® as an adjunctive therapy with current immunosuppression agents to manage organ rejection.

Intralipid Vehicle Does Not Interfere with the Efficacy of Progesterone in Attenuating Edema following Traumatic Brain Injury.

The recent disappointing results of phase III trials for progesterone (PROG) in traumatic brain injury (TBI) have triggered speculation about reasons for the negative outcomes. One confounding factor may have been the vehicle used to administer PROG. Virtually all of the many pre-clinical experiments informing the clinical trials and reporting beneficial PROG effects used more soluble 2-hydroxypropyl-b-cyclodextrin as a vehicle given intraperitoneally or subcutaneously rather than a lipid formulation given intravenously (IV). The present investigation compared the effect of PROG infusion with that of lipid emulsion (Intralipid®) as a carrier/vehicle on edema following TBI in rats. Eight-mg/kg doses of PROG with 20% Intralipid were given IV via central venous catheter beginning 1 h post-injury over a 1 h duration (1.2 mL/h). Animals were killed and brains removed at 24 h post-injury. All the brain-injured groups showed more edema compared with the control group. However, PROG+Intralipid significantly attenuated cerebral swelling compared with Intralipid alone. No difference was observed between the TBI-alone and Intralipid groups. Although this study used much a smaller volume and shorter duration of Intralipid infusion than the clinical trials (up to 5 days of continuous infusion), our results suggest that the use of Intralipid in rats did not prevent or mask the beneficial effect of PROG.

Changes of Total Plasma Triglycerides in Neonates Treated With Intralipid: A Pilot Study.

Dear Editor, The current scientific literature states that Intralipid 10% emulsion has a higher ratio of phospholipids to triglycerides, and contains more lypozomal phospholipids as compared to Intralipid 20% and Intralipid 30%, so it causes higher plasma concentrations of triglycerides, cholesterol and phospholipids (1, 2). It should be noted that serum triglycerides concentration is used as a marker for lipid tolerance and predicting the probability of complications involved with the administration of Intralipid 10%. In view of the fact that Intralipid 10% emulsion is the only currently available Intralipid in Iran, and also used for years, is known to have no significant side effects, we conducted a before and after descriptive, observational study on 20 newborns (10 females and 10 males) hospitalized in NICU of Valiasr hospital, Tehran University of Medical Sciences, that required total intravenous nutrition, and evaluated the effects of Intralipid 10% on neonates’ total plasma triglycerides before TPN and once the dose of Intralipid reached 2.5 g/kg/day. In the first step total plasma triglycerides level was measured. Then continuous daily infusion of Intralipid 10% with 0.5 g/kg/day dose was started increasing daily 0.5 g/kg until enteral nutrition was able to provide approximately 100 to 110 kcal for kg body weight. The outcome was total plasma triglycerides levels higher than 200 mg/dL in newborns receiving intravenous Intralipid 10% nutrition. Heparin was administered routinely with parenteral nutrition; heparin can theoretically release lipase lipoprotein from endothelial cells that may accelerate clearance of lipids from plasma. Total plasma triglycerides was monitored weekly when the Intralipid 10% dosage reached 2.5 g/kg/day and was continued to the end of TPN therapy, or until it reached the maximum level of 150-200 mg/dL, defined in scientific references as the indication for termination of intravenous Intralipid administration. There were no significant differences observed between total plasma triglycerides level before intravenous feeding (62.95 ± 10.46 mg/dL) and after Intralipid terminating dose of 2.5 gr/kg/day (63.15 ± 12.98 mg/dL) (P = 0.9). Also no correlation was observed between birth weight, duration of intravenous feeding and plasma triglycerides level difference (P > 0.005). Viewing the results of this study which has been referred to in detail, we intend to indicate that no significant difference between total plasma triglyceride levels before intravenous feeding and total plasma triglyceride levels after Intralipid 10% dosage has reached 2.5 g/kg/day, was seen (P = 0.9). This study in accordance with previously published studies (3-6) showed that Intralipid 10% is well tolerated by patients and levels of plasma triglycerides did not increase, VLDL and HDL remained in normal range and no significant complication was observed. The last noteworthy point is that the length of infusion can also be an important parameter in modulating possible listed side effects of Intralipid 10% mentioned in other sources. In conclusion, this study showed that in the absence of Intralipid 20% or 30%, the use of Intralipid 10% has not led to high levels of triglycerides in our neonates.

Use of intralipid for local anesthetic toxicity in neonates

Use of intralipid for local anesthetic toxicity in neonates

Plasma apolipoprotein C-III metabolism in patients with chronic kidney disease

Moderate chronic kidney disease (CKD) (defined by an estimated glomerular filtration rate of 30-60 ml/min) is associated with mild hypertriglyceridemia related to delayed catabolism of triglyceride-rich lipoprotein particles. Altered apolipoprotein C-III (apoC-III) metabolism may contribute to dyslipidemia in CKD. To further characterize the dyslipidemia of CKD, we investigated the kinetics of plasma apoC-III in 7 nonobese, nondiabetic, non-nephrotic CKD subjects and 7 age- and sex-matched healthy controls, using deuterated leucine ([5, 5, 5, ²H₃]leucine), gas chromatography-mass spectrometry, and multicompartmental modeling. Compared with controls, CKD subjects had higher concentrations of plasma and VLDL triglycerides and plasma and VLDL apoC-III (P < 0.05). The increased plasma apoC-III concentration was associated with a decreased apoC-III fractional catabolic rate (FCR) (1.21 ± 0.15 vs. 0.74 ± 0.12 pools/day, P = 0.03). There were no differences between apoC-III production rates of controls and those of CKD subjects. In CKD subjects, plasma apoC-III concentration was significantly and negatively correlated with apoC-III FCR (r = -0.749, P = 0.05) but not with apoC-III production rate. Plasma apoC-III concentration was positively correlated with plasma and VLDL triglycerides and VLDL apoB concentrations and negatively correlated with VLDL apoB FCR (P < 0.05 for all). ApoC-III FCR was negatively correlated with plasma and VLDL triglycerides and VLDL apoB concentration and positively correlated with VLDL apoB FCR (P < 0.05 for all). Altered plasma apoC-III metabolism is a feature of dyslipidemia in moderate CKD. Modification of apoC-III catabolism may be an important therapeutic target for reducing cardiovascular disease risk in moderate CKD.

Effects of Intralipid‐10% in fluorescence distortion studies on liquid‐tissue phantoms in UV range

In biomedical optical spectroscopy tissue-mimicking phantoms have been widely used for imitating optical properties of biological tissues. As tissue is a turbid medium involving scatterers, absorbing and fluorescing molecules, modelling a tissue in the form of a phantom should have the same realistic complexity comparable to that of tissues. In optical spectroscopy, fluorescence phenomena have been extensively investigated as an optical technique for disease diagnosis. The fluorescence signal is distorted by optical properties of a biological tissue. The purpose of this study is to investigate whether the use of Intralipid as a scattering agent in a turbid medium containing fluorophores can affect fluorescent intensity by the phenomena of scattering and collisional quenching. The results indicate that phantom sets with different concentrations of Tyrosine and Intralipid have their emission peaks distorted at 300 nm and also show secondary peaks when used for fluorescence studies in UV region.

The Use of Intralipid in the Management of a Mixed Overdose

A 34-year-old man took a mixed overdose of multiple lipid-soluble drugs. He did not respond to maximal medical therapy but improved after the introduction of Intralipid. The possible mechanisms of action and potential adverse consequences of using Intralipid in this context are reviewed.

Intralipid reverses coma associated with zopiclone and venlafaxine overdose

Intralipid reverses coma associated with zopiclone and venlafaxine overdose

Availability of and use of Intralipid (lipid rescue therapy, lipid emulsion) in England and Wales

There is increasing evidence for the use of Intralipid in the management of acute local anaesthetic toxicity. This is supported by the recent Association of Anaesthetists of Great Britain and...

The use of Intralipid for unconsciosness after a mixed overdose

The use of Intralipid for unconsciosness after a mixed overdose

The Successful Use of Intralipid for Treatment of Local Anesthetic-induced Central Nervous System Toxicity

Intralipid has been proposed as a treatment option for local anesthetic (LA) toxicity, which does not respond to traditional resuscitation methods. This paper presents a case report of a patient who developed signs of local anesthetic toxicity and was subsequently treated with 20% Intralipid with a positive response. Some background and practical applications regarding this treatment are discussed.

Use of Intralipid in an infant with impending cardiovascular collapse due to local anesthetic toxicity

Local anesthetic-associated cardiac toxicity following caudal epidural blockade is, fortunately, a rare event. Prompt recognition and early treatment is the key to successful resuscitation. Early use of the lipid emulsion Intralipid in bupivacaine-induced cardiac toxicity may lead to a good outcome.

Dose of lipid emulsion in obstetric anaesthesia in the UK

We read with interest the article on the availability of lipid emulsion in obstetric anaesthesia in the UK and would like to congratulate the authors [1]. Our hospital had drafted its own protocol for use of Intralipid before the AAGBI guidelines [2] were published. We feel the need to highlight the fact that the above article says that most labour wards included in the survey used regimens that were based on two versions suggested by Weinberg et al. [3, 4]. On referring to the original articles, most of the references included by the authors and the AAGBI guidelines on the use of Intralipid for treatment of local anaesthetic toxicity, we found that all recommend the dose of Intralipid as 1.5 ml.kg−1 of 20% solution which amounts to 21 g for a 70-kg patient. Williamson and Haines mention a dose of 1.5 mg.kg−1 of Intralipid 20% which amounts to 105 mg for a 70-kg patient. There is a huge dose difference in the two mentioned dose regimens and it needs to be clarified that the dose recommended in all the references is ml.kg−1 of 20% Intralipid solution rather than mg.kg−1.

Local anaesthetic toxicity

Background: Local anaesthesia has been used by British podiatrists since the early 1960s. The use of local anaesthesia has allowed for the advancement of scope of practice and the development of podiatric surgery. Local anaesthesia is however associated with potential risks and adverse reactions including toxicity. Objectives: To review the current literature on the subject of local anaesthetic toxicity and to consider recent developments in the management of acute toxicity. Conclusions: Local anaesthesia although safe has the potential to cause serious harm in the event of toxicity. Appropriate steps should be taken to minimise the risk of toxicity and should it occur measures should be applied to minimise the consequences of toxicity. Such measures may include the use of Intralipid for resuscitation.