Evidence-based recommendations on the use of intravenous lipid emulsion therapy in poisoning*

Published on Sep 8, 2016in Clinical Toxicology4.467
· DOI :10.1080/15563650.2016.1214275
Sophie Gosselin24
Estimated H-index: 24
(MUHC: McGill University Health Centre),
Lotte C. G. Hoegberg15
Estimated H-index: 15
(Copenhagen University Hospital)
+ 16 AuthorsValery Lavergne27
Estimated H-index: 27
(UdeM: Université de Montréal)
AbstractBackground: Although intravenous lipid emulsion (ILE) was first used to treat life-threatening local anesthetic (LA) toxicity, its use has expanded to include both non-local anesthetic (non-LA) poisoning and less severe manifestations of toxicity. A collaborative workgroup appraised the literature and provides evidence-based recommendations for the use of ILE in poisoning.Methods: Following a systematic review of the literature, data were summarized in four publications: LA and non-LA poisoning efficacy, adverse effects, and analytical interferences. Twenty-two toxins or toxin categories and three clinical situations were selected for voting. Voting statements were proposed using a predetermined format. A two-round modified Delphi method was used to reach consensus on the voting statements. Disagreement was quantified using RAND/UCLA Appropriateness Method.Results: For the management of cardiac arrest, we recommend using ILE with bupivacaine toxicity, while our recommendations are neutral regardin...
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