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Intravenous lipid emulsions - a new method for the treatment of acute intoxications with lipophilic drugs

Gabriela Kehayova, Snezha Zlateva, Petko Marinov


Introduction: The use of intravenous lipid emulsions (LEs) is a new method of treating lipophilic drug intoxications. Useful mechanisms of action of LE include intravascular sequestration of the toxicant and subsequent enhanced redistribution to biologically inert tissues, increased use of fatty acids for ATP synthesis as well as direct positive cardiac inotropic effect. Although not a validated healing method, LE provides lifesaving therapy to hundreds of patients worldwide.

Aims: The aim of this article is to analyze the results of published studies on experimental animals and humans, to prove the cardioprotective effect of LE as a new method for the treatment of acute exogenous lipophilic drug intoxications in induced cardiac injury.

Material and Methods: A systematic review of studies, demonstrating successful resuscitation of humans and animals as a result of poisoning with cardiotoxic lipophilic drugs was conducted.

Results: Hundreds of reports announce successful resuscitation of humans and experimental animals poisoned with lipophilic drugs such as beta blockers, calcium blockers, neuroleptics, and antidepressants. Increased survival after LE infusion was reported in rats poisoned with verapamil. Less pronounced rhythm and conduction disturbances, hemodynamic stabilization and a shorter recovery period were observed in patients treated with LE.

Conclusion: Based on the hundreds of studies in humans and animals, it can be concluded that LE can be useful in treating any overdose with lipophilic drugs in addition to standard resuscitation protocols. Although it is not yet a first-line treatment method, the use of LE should be seriously considered, especially in cases of unsuccessful resuscitation.


lipid emulsions; acute intoxications; parenteral nutrition; lipophilic drugs

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