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1.
Journal of The Korean Society of Clinical Toxicology ; : 1-10, 2015.
Article in Korean | WPRIM | ID: wpr-94927

ABSTRACT

PURPOSE: The purpose of this study was to evaluate the usefulness of intravenous lipid emulsion as well as adverse events in acute poisoning patients. METHODS: Literature was accessed through PubMed, EMBASE, Cochrane library, Web of science, and KoreaMed. All forms of literatures relevant to human use of intravenous lipid emulsion for acute poisoning were included. Cases reports or letters without description of clinical outcomes for each case were excluded. The literature search was conducted by two investigators in March, 2015, with publication language restricted to English and Korean. The effect, onset time, and adverse event of lipid emulsion and final outcome of each case were analyzed. RESULTS: Eighty-one published articles were included, excluding articles whose title and abstract were not relevant to this study. No articles were classified as high level of evidence. Sixty-eight case reports were identified, consisting of 25 local anesthetics and 43 other drugs, such as tricyclic antidepressants and calcium channel blockers. Although most cases described significant clinical improvements, some of them showed no beneficial effect or worsening of clinical course. Several adverse events including hyperamylasemia and laboratory interference were reported. CONCLUSION: Although there were many case reports illustrating successful use of lipid for various drug poisonings, the effect cannot be estimated due to significant possibility of publication bias. Therefore, lipids might be considered in severe hemodynamic instability resulting from lipophilic drug poisoning, however further studies should follow to establish the use of lipid as the standard of care.


Subject(s)
Humans , Anesthetics, Local , Antidepressive Agents, Tricyclic , Calcium Channel Blockers , Drug Overdose , Fat Emulsions, Intravenous , Hemodynamics , Hyperamylasemia , Lipid A , Poisoning , Publication Bias , Publications , Research Personnel , Standard of Care
2.
The Korean Journal of Critical Care Medicine ; : 234-236, 2014.
Article in English | WPRIM | ID: wpr-651806

ABSTRACT

Unexpected occurrence of local anesthetic toxicity is not rare and can cause fatal complications that do not respond to any known drug of intervention. Recently, the successful use of lipid emulsion for local anesthetic toxicity has been reported and recommended as a rescue method for cardiac or neurologic complications. We report a case of seizure attack and respiratory arrest successfully recovered with the use of intravenous lipid emulsion. Clinicians must be aware of the beneficial role of lipid emulsion in cases of local anesthetic toxicity.


Subject(s)
Anesthetics, Local , Ankle , Antidotes , Fat Emulsions, Intravenous , Neurotoxicity Syndromes , Resuscitation , Seizures
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