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Review ArticleReview Article
Open Access

Use of lipid emulsion therapy in local anesthetic overdose

Ozgur Karcioglu
Saudi Medical Journal October 2017, 38 (10) 985-993; DOI: https://doi.org/10.15537/smj.2017.10.20525
Ozgur Karcioglu
From the Department of Emergency Medicine, University of Health Sciences, Istanbul Education and Research Hospital, Istanbul, Turkey
MD
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References

  1. ↵
    1. Wanten GJA
    (2015) Parenteral lipid tolerance and adverse effects: fat chance for trouble? JPEN J Parenter Enteral Nutr 39(Suppl 1):33S–38S.
    OpenUrlCrossRefPubMed
  2. ↵
    1. Vanek VW,
    2. Seidner DL,
    3. Allen P,
    4. Bistrian B,
    5. Collier S,
    6. Gura K,
    7. et al.
    (2012) Novel Nutrient Task Force, Intravenous Fat Emulsions Workgroup, American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.) Board of Directors. A.S.P.E.N. position paper: Clinical role for alternative intravenous fat emulsions. Nutr Clin Pract 27:150–192.
    OpenUrlCrossRefPubMed
  3. ↵
    1. Jamaty C,
    2. Bailey B,
    3. Larocque A,
    4. Notebaert E,
    5. Sanogo K,
    6. Chauny JM
    (2010) Lipid emulsions in the treatment of acute poisoning: a systematic review of human and animal studies. Clin Toxicol (Phila) 48:1–27.
    OpenUrlCrossRefPubMed
  4. ↵
    1. Christian MR,
    2. Pallasch EM,
    3. Wahl M,
    4. Mycyk MB
    (2013) Lipid rescue 911: Are poison centers recommending intravenous fat emulsion therapy for severe poisoning? J Med Toxicol 9:231–234.
    OpenUrlCrossRefPubMed
  5. ↵
    1. Presley JD,
    2. Chyka PA
    (2013) Intravenous lipid emulsion to reverse acute drug toxicity in pediatric patients. Ann Pharmacother 47:735–743.
    OpenUrlCrossRefPubMed
  6. ↵
    1. Weinberg G,
    2. Lin B,
    3. Zheng S,
    4. Di Gregorio G,
    5. Hiller D,
    6. Ripper R,
    7. et al.
    (2010) Partitioning effect in lipid resuscitation: further evidence for the lipid sink. Crit Care Med 38:2268–2269.
    OpenUrlCrossRefPubMedWeb of Science
    1. Mazoit JX,
    2. Le Guen R,
    3. Beloeil H,
    4. Benhamou D
    (2009) Binding of longlasting local anesthetics to lipid emulsions. Anesthesiology 110:380–386.
    OpenUrlPubMedWeb of Science
  7. ↵
    1. Samuels TL,
    2. Willers JW,
    3. Uncles DR,
    4. Monteiro R,
    5. Halloran C,
    6. Dai H
    (2012) In vitro suppression of drug-induced methaemoglobin formation by intralipid 1 in whole human blood: observations relevantto the ‘lipid sink theory’ Anaesthesia 67:23–32.
    OpenUrlCrossRefPubMed
  8. ↵
    1. French D,
    2. Smollin C,
    3. Ruan W,
    4. Wong A,
    5. Drasner K,
    6. Wu AH
    (2011) Partition constant and volume of distribution as predictors of clinical efficacy of lipid rescue for toxicological emergencies. Clin Toxicol (Phila) 49:801–809.
    OpenUrlCrossRefPubMed
  9. ↵
    1. Gueret G,
    2. Pennec JP,
    3. Arvieux CC
    (2007) Hemodynamic effects of intralipid after verapamil intoxication may be due to a direct effect of fatty acids on myocardial calcium channels. Acad Emerg Med 14:761.
    OpenUrlCrossRefPubMed
  10. ↵
    1. Hoare T,
    2. Sivakumaran D,
    3. Stefanescu C,
    4. Lawlor MW,
    5. Kohane DS
    (2012) Nanogel scavengers for drugs: local anesthetic uptake by thermoresponsive nanogels. Acta Biomater 8:1450–1458.
    OpenUrlPubMed
  11. ↵
    1. Nouette-Gaulain K,
    2. Capdevila X,
    3. Robin F,
    4. Beloeil H
    (2014) [Intravenous lipid emulsion and local anesthetic-induced systemic toxicity: mechanisms and limits]. Ann Fr Anesth Reanim 33:411–417, French.
    OpenUrl
  12. ↵
    1. Rahman S,
    2. Li J,
    3. Bopassa JC,
    4. Umar S,
    5. Iorga A,
    6. Partownavid P,
    7. et al.
    (2011) Phosphorylation of GSK-3aˆmediates intralipid-induced cardioprotection against ischemia/reperfusion injury. Anesthesiology 115:242–253.
    OpenUrlCrossRefPubMedWeb of Science
  13. ↵
    1. Cave G,
    2. Harvey MG
    (2014) Should we consider the infusion of lipid emulsion in the resuscitation of poisoned patients? Crit Care 18:457.
    OpenUrl
  14. ↵
    1. Litonius E,
    2. Tarkkila P,
    3. Neuvonen PJ,
    4. Rosenberg PH
    (2012) Effect of intravenous lipid emulsion on bupivacaine plasma concentration in humans. Anaesthesia 67:600–605.
    OpenUrlCrossRefPubMedWeb of Science
    1. Heinonen JA,
    2. Litonius E,
    3. Salmi T,
    4. Haasio J,
    5. Tarkkila P,
    6. Backman JT,
    7. et al.
    (2015) Intravenous lipid emulsion given to volunteers does not affect symptoms of lidocaine brain toxicity. Basic Clin Pharmacol Toxicol 116:378–383.
    OpenUrlCrossRefPubMed
  15. ↵
    1. Dureau P,
    2. Charbit B,
    3. Nicolas N,
    4. Benhamou D,
    5. Mazoit JX
    (2016) Effect of Intralipid®on the Dose of Ropivacaine or Levobupivacaine Tolerated by Volunteers: A Clinical and Pharmacokinetic Study. Anesthesiology 125:474–483.
    OpenUrl
  16. ↵
    1. Taftachi F,
    2. Sanaei-Zadeh H,
    3. Sepehrian B,
    4. Zamani N
    (2012) Lipid emulsion improves Glasgow coma scale and decreases blood glucose level in the setting of acute non-local anesthetic drug poisoning--a randomized controlled trial. Eur Rev Med Pharmacol Sci 16(Suppl1):38–42.
    OpenUrlPubMed
  17. ↵
    1. Zhou RH,
    2. Yu H,
    3. Yin XR,
    4. Li Q,
    5. Yu H,
    6. Yu H,
    7. et al.
    (2017) Effect of intralipid postconditioning on myocardial injury in patients undergoing valve replacement surgery: a randomised controlled trial. Heart 103:1122–1127.
    OpenUrlAbstract/FREE Full Text
  18. ↵
    1. Wu G,
    2. Sun B,
    3. Liu LI,
    4. Zhou J,
    5. Mo L,
    6. Ren C,
    7. et al.
    (2015) Lipid emulsion mitigates local anesthesia-induced central nervous system toxicity in rats. Exp Ther Med 10:1133–1138.
    OpenUrl
  19. ↵
    1. Fettiplace MR,
    2. Akpa BS,
    3. Ripper R,
    4. Zider B,
    5. Lang J,
    6. Rubinstein I,
    7. et al.
    (2014) Resuscitation with lipid emulsion: dose-dependent recovery from cardiac pharmacotoxicity requires a cardiotonic effect. Anesthesiology 120:915–925.
    OpenUrlCrossRefPubMed
  20. ↵
    1. Fettiplace MR,
    2. Lis K,
    3. Ripper R,
    4. Kowal K,
    5. Pichurko A,
    6. Vitello D,
    7. et al.
    (2015) Multi-modal contributions to detoxification of acute pharmacotoxicity by a triglyceride micro-emulsion. J Control Release 198:62–70.
    OpenUrlCrossRefPubMed
  21. ↵
    1. Levine M,
    2. Hoffman RS,
    3. Lavergne V,
    4. Stork CM,
    5. Graudins A,
    6. Chuang R,
    7. et al.
    (2016) Lipid Emulsion Workgroup. Systematic review of the effect of intravenous lipid emulsion therapy for non-local anesthetics toxicity. Clin Toxicol (Phila) 54:194–221.
    OpenUrl
  22. ↵
    1. Hoegberg LC,
    2. Bania TC,
    3. Lavergne V,
    4. Bailey B,
    5. Turgeon AF,
    6. Thomas SH,
    7. et al.
    (2016) Lipid Emulsion Workgroup. Systematic review of the effect of intravenous lipid emulsion therapy for local anesthetic toxicity. Clin Toxicol (Phila) 54:167–193.
    OpenUrl
  23. ↵
    1. Mauch J,
    2. Martin Jurado O,
    3. Spielmann N,
    4. Bettschart-Wolfensberger R,
    5. Weiss M
    (2011) Comparison of epinephrine vs lipid rescue to treat severe local anesthetic toxicity - an experimental study in piglets. Paediatr Anaesth 21:1103–1108.
    OpenUrlCrossRefPubMed
  24. ↵
    1. de Queiroz Siqueira M,
    2. Chassard D,
    3. Musard H,
    4. Heilporn A,
    5. Cejka JC,
    6. Leveneur O,
    7. et al.
    (2014) Resuscitation with lipid, epinephrine, or both in levobupivacaine-induced cardiac toxicity in newborn piglets. Br J Anaesth 112:729–734.
    OpenUrlCrossRefPubMedWeb of Science
  25. ↵
    1. Li B,
    2. Yan J,
    3. Shen Y,
    4. Li B,
    5. Hu Z,
    6. Ma Z
    (2012) Association of sustained cardiovascular recovery with epinephrine in the delayed lipid-based resuscitation from cardiac arrest induced by bupivacaine overdose in rats. Br J Anaesth 108:857–863.
    OpenUrlCrossRefPubMedWeb of Science
  26. ↵
    1. Young AC,
    2. Velez LI,
    3. Kleinschmidt KC
    (2009) Intravenous fat emulsion therapy for intentional sustained-release verapamil overdose. Resuscitation 80:591.
    OpenUrlCrossRefPubMedWeb of Science
  27. ↵
    1. Sirianni AJ,
    2. Osterhoudt KC,
    3. Calello DP,
    4. Muller AA,
    5. Waterhouse MR,
    6. Goodkin MB,
    7. et al.
    (2008) Use of lipid emulsion in the resuscitation of a patient with prolonged cardiovascular collapse after overdose of bupropion and lamotrigine. Ann Emerg Med 51:412.
    OpenUrlCrossRefPubMedWeb of Science
  28. ↵
    1. Lam SHF,
    2. Majlesi N,
    3. Vilke GM
    (2016) Use of intravenous fat emulsion in the emergency department for the critically ill poisoned patient. J Emerg Med 51:203–214.
    OpenUrl
  29. ↵
    1. Low E,
    2. Ryan CA
    (2007) Overdose of intravenous Intralipid in a premature neonate. Jt Comm J Qual Patient Saf 33:588–589.
    OpenUrlPubMed
  30. ↵
    1. American College of Medical Toxicology
    (2011) ACMT Position Statement: Interim Guidance for the Use of Lipid Resuscitation Therapy. J Med Toxicol 7:81–82.
    OpenUrlCrossRefPubMed
  31. ↵
    1. Hayes BD,
    2. Gosselin S,
    3. Calello DP,
    4. Nacca N,
    5. Rollins CJ,
    6. Abourbih D,
    7. et al.
    (2016) Lipid Emulsion Workgroup. Systematic review of clinical adverse events reported after acute intravenous lipid emulsion administration. Clin Toxicol (Phila) 54:365–404.
    OpenUrlCrossRef
  32. ↵
    1. Grunbaum AM,
    2. Gilfix BM,
    3. Gosselin S,
    4. Blank DW
    (2012) Analytical interferences resulting from intravenous lipid emulsion. Clin Toxicol (Phila) 50:812–817.
    OpenUrlCrossRefPubMed
  33. ↵
    1. Grunbaum AM,
    2. Gilfix BM,
    3. Hoffman RS,
    4. Lavergne V,
    5. Morris M,
    6. Miller-Nesbitt A,
    7. et al.
    (2016) Review of the effect of intravenous lipid emulsion on laboratory analyses. Clin Toxicol (Phila) 54:92–102.
    OpenUrl
  34. ↵
    1. Lee HM,
    2. Archer JR,
    3. Dargan PI,
    4. Wood DM
    (2015) What are the adverse effects associated with the combined use of intravenous lipid emulsion and extracorporeal membrane oxygenation in the poisoned patient? Clin Toxicol (Phila) 53:145–150.
    OpenUrlCrossRefPubMed
  35. ↵
    1. Mowry JB,
    2. Spyker DA,
    3. Cantilena LR,
    4. McMillan N,
    5. Ford M
    (2014) 2013 Annual report of the American Association of Poison Control Centers’ National Poison Data System (NPDS):31st annual report. Clin Toxicol 52:1032–1283.
    OpenUrlCrossRef
  36. ↵
    1. Weinberg GL,
    2. VadeBoncouer T,
    3. Ramaraju GA,
    4. Garcia-Amaro MF,
    5. Cwik MJ
    (1998) Pretreatment or resuscitation with a lipid infusion shifts the dose-response to bupivacaine-induced asystole in rats. Anesthesiology 88:1071–1075.
    OpenUrlCrossRefPubMedWeb of Science
  37. ↵
    1. Bern S,
    2. Akpa BS,
    3. Kuo I,
    4. Weinberg G
    (2011) Lipid resuscitation: a life-saving antidote for local anesthetic toxicity. Curr Pharm Biotechnol 12:313–319.
    OpenUrlPubMed
  38. ↵
    1. Harvey M,
    2. Cave G,
    3. Kazemi A
    (2009) Intralipid infusion diminishes return of spontaneous circulation after hypoxic cardiac arrest in rabbits. Anesth Analg 108:1163–1168.
    OpenUrlCrossRefPubMed
  39. ↵
    1. Bern S,
    2. Weinberg G
    (2011) Local anesthetic toxicity and lipid resuscitation in pregnancy. Curr Opin Anaesthesiol 24:262–267.
    OpenUrlCrossRefPubMed
  40. ↵
    1. Ozcan MS,
    2. Weinberg G
    (2014) Intravenous lipid emulsion for the treatment of drug toxicity. J Intensive Care Med 29:59–70.
    OpenUrlCrossRefPubMed
  41. ↵
    1. Gosselin S,
    2. Hoegberg LC,
    3. Hoffman RS,
    4. Graudins A,
    5. Stork CM,
    6. Thomas SH,
    7. et al.
    (2016) Evidence-based recommendations on the use of intravenous lipid emulsion therapy in poisoning. Clin Toxicol (Phila) 54:899–923.
    OpenUrlCrossRef
  42. ↵
    1. Rosenthal G,
    2. Wetsch WA,
    3. Neumann T,
    4. Padosch SA,
    5. Böttiger BW,
    6. Marcus HE
    (2016) Local anesthetic toxicity: Who is ready for lipid resuscitation?A survey of German Hospitals. Anaesthesist 65:267–273.
    OpenUrl
    1. Harvey M,
    2. Cave G
    (2017) Lipid emulsion in local anesthetic toxicity. Curr Opin Anaesthesiol 7:doi:10.1097/ACO.0000000000000498. [Epub ahead of print].
    1. Fettiplace MR,
    2. McCabe DJ
    (2017) Lipid emulsion improves survival in animal models of local anesthetic toxicity: a meta-analysis. Clin Toxicol (Phila) 55:617–623.
    OpenUrl
    1. Mithani S,
    2. Dong K,
    3. Wilmott A,
    4. Podmoroff H,
    5. Lalani N,
    6. Rosychuk RJ,
    7. et al.
    (2017) A cohort study of unstable overdose patients treated with intravenous lipid emulsion therapy. CJEM 19:256–264.
    OpenUrl
    1. Cao D,
    2. Heard K,
    3. Foran M,
    4. Koyfman A
    (2015) Intravenous lipid emulsion in the emergency department: a systematic review of recent literature. J Emerg Med 48:387–397.
    OpenUrlCrossRefPubMed
    1. Cave G,
    2. Harvey M,
    3. Graudins A
    (2011) Intravenous lipid emulsion as antidote: a summary of published human experience. Emerg Med Australas 23:123–141.
    OpenUrlCrossRefPubMed
    1. Chai PR,
    2. Hack JB
    (2016) Intravenous lipid emulsion in the resuscitation of cocaine-induced cardiovascular arrest in a rat model. Am J Emerg Med 34:1452–1454.
    OpenUrl
    1. Di Gregorio G,
    2. Schwartz D,
    3. Ripper R,
    4. Kelly K,
    5. Feinstein DL,
    6. Minshall RD,
    7. et al.
    (2009) Lipid emulsion is superior to vasopressin in a rodent model of resuscitation from toxin-induced cardiac arrest. Crit Care Med 37:993–999.
    OpenUrlCrossRefPubMedWeb of Science
    1. Liu L,
    2. Xia Y,
    3. Chen Y,
    4. Wang Q,
    5. Shi T,
    6. Wang F,
    7. et al.
    (2012) The comparative effects of lipid, epinephrine, and their combination in the reversal of bupivacaine-induced asystole in the isolated rat heart. Anesth Analg 114:886–893.
    OpenUrlCrossRefPubMedWeb of Science
    1. Heinonen JA,
    2. Skrifvars MB,
    3. Haasio J,
    4. Backman JT,
    5. Rosenberg PH,
    6. Litonius E
    (2016) Intravenous lipid emulsion for levobupivacaine intoxication in acidotic and hypoxaemic pigs. Anaesth Intensive Care 44:270–277.
    OpenUrlPubMed
    1. Gosselin S,
    2. Hoegberg LC,
    3. Hoffman RS,
    4. Graudins A,
    5. Stork CM,
    6. Thomas SH,
    7. et al.
    (2016) Evidence-based recommendations on the use of intravenous lipid emulsion therapy in poisoning. Clin Toxicol (Phila) 54:899–923.
    OpenUrlCrossRef
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Use of lipid emulsion therapy in local anesthetic overdose
Ozgur Karcioglu
Saudi Medical Journal Oct 2017, 38 (10) 985-993; DOI: 10.15537/smj.2017.10.20525

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Use of lipid emulsion therapy in local anesthetic overdose
Ozgur Karcioglu
Saudi Medical Journal Oct 2017, 38 (10) 985-993; DOI: 10.15537/smj.2017.10.20525
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