Excellent review of lipid rescue therapy

3.5 out of 5 stars Intravenous Lipid Emulsion in the Emergency Department: A Systematic Review of Recent Literature. Cao D et al. J Emerg Med 2014 Dec 19 [Epub ahead of print] Abstract This excellent comprehensive review of lipid rescue therapy (LRT) is vitiated only by the unavoidable fact that available clinical evidence  is so inconclusive. As the authors point out, published literature consists mostly of case reports and small case series. The vast majority of these reported cases have good outcomes and reflect positive effects from ILE, but the evidence is marred by multiple confounding variables (such as concurrent treatment) that are impossible to correct for, and by publication bias. There have been no prospective randomized controlled trials.Intravenous lipid emulsion is now considered first-line therapy for local anesthetic systemic toxicity (LAST,) but generally reserved as a last-ditch effort for patients severely ill from other drugs who are not responding to more established interventions. The authors conducted an extensive literature review to identify publications describing human overdose cases treated with LRT in which outcomes were reported. They found 94 articles and 40 abstracts, which are cited in a very complete bibliography current to 2014. This entire review is well worth reading. I will touch on some points I found particularly interesting. Table 1 lists the different drugs involved in overdose cases where LRT was used, along with whether the obse...
Source: The Poison Review - Category: Toxicology Authors: Tags: Medical intralipid lipid emulsion lipid rescue therapy lipid sink Review Source Type: news