Its mechanisms of action may include movement of drugs from the tissues to equilibrate in a larger circulating lipid pool (so-called ‘lipid sink’), and restoration of metabolic pathways within cardiomyocytes.

The fatty acids composing the emulsions may be saturated or unsaturated, stem from medium- and long-chain triglycerides with various pharmaceutical and metabolic activities which improved the safety and efficacy of these compounds in time. Therefore, intravenous fat emulsions are a main component of nutrition, which helps to prevent essential fatty acid deficiency and can also be used as an alternate energy source to dextrose, avoiding the complications of excessive dextrose administration. This fish oil-based fat emulsion is not merely a nutrient and an alternate energy source it has also substantial anti-inflammatory effects and conveys significant pharmacological value. In the following decades, second-, third- and finally in 2000’s, the fourth-generation fat emulsion were developed in accord with the changing needs which tends to increase the olive oil and fish oil content while decreasing the soybean oil mixture. The introduction of the first successful Intravenous Lipid Emulsion Therapy (IVLET) in the sixties was heralded as a major breakthrough in parenteral nutrition support. Keywords: Lipid emulsion therapy Lipid emulsion Poisoning Intoxication Calcium-channel blockers β-blockers What do we know about lipid emulsions? The purpose of this review is to highlight recent advances in our understanding of the efficacy and safety of IVLET, with special regard to its use in toxicity with cardioactive compounds. IVLET may be considered for resuscitation by emergency physicians in resuscitation of severe hemodynamic compromise by lipid-soluble cardioactive xenobiotics. Meanwhile, disturbed laboratory values associated with IVLET comprise hyperlipemia, hypercoagulability, and rarely, thrombocytopenia in neonates. Patients with hypotension refractory to volume loading, correction of acidosis and calcium salts should be treated using High-dose insulin Euglycemia Therapy (HET).Īdverse effects from standard IVLET include hypertriglyceridemia, fat embolism, infection, local vein irritation, acute pancreatitis, electrolyte disturbances and hypersensitivity and allergic reactions. In cases of cardiac arrest from a suspected poisoning, consider administration of intravenous lipid emulsion during the resuscitation.

The present evidence supports use of IVLET in local anesthetic overdoses and in lipophilic cardiotoxin intoxication-including CCB and BB-when there is an immediate threat to life, and other therapies have failed. We performed a review and critical analysis of the most recent literature to analyse consequences, use and potential adverse effects associated with this treatment modality in poisoning with cardioactive drugs. CCB and BB represent two of the most important classes of cardiovascular drugs involved in producing cardiodepressive syndrome. Lipid resuscitation therapy is the administration of an Intravenous Lipid Emulsion Therapy (IVLET) in order to alleviate clinical manifestations of toxicity from certain overdoses, including local anesthetics, Calcium-Channel Blockers (CCB), β-Blockers (BB), antipsychotics, antidepressants and other drugs. *Corresponding author: Ozgur Karcioglu, Department ofĬite this article as: Karcioglu O. Review Article Utility and Untoward Effects of Lipid Emulsion Therapy in Patients with Poisoning by Cardioactive Drugsĭepartment of Emergency Medicine, University of Health Sciences, Istanbul, Turkey

Iv lipid emulsion therapy indications