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CES Medicina
Print version ISSN 0120-8705
Abstract
CARDENAS-ALVAREZ, JORGE EDUARDO and BERROUET-MEJIA, MARIE CLAIRE. Use of lipid emulsions in poisoning by local anesthetics and other poisonings: current evidence. CES Med. [online]. 2014, vol.28, n.1, pp.77-90. ISSN 0120-8705.
Objective: To perform a narrative review with evidence of the composition mechanism of action and indications for the use of lipid emulsions as an antidote in local anesthetic toxicity and other poisonings. Methods: We performed a bibliographic research by using PubMed, Scielo and Lilacs using the keywords "lipid emulsion therapy toxicology", "lipid therapy toxicology", "intravenous lipid therapy toxicology", "fat emulsion toxicology" and "lipid sink", identifying relevant information related to, published between 1960 and 2013. Results: Lipid emulsions have been used as a nutritional supplement, its use is also approved for the treatment of poisoning by local anesthetics such as bupivacaine through different mechanisms of action such as: the effect of lipid sink, lipid flux and effects on transport fatty acids in mitochondria, among others. Although the results in other poisonings as beta-blockers, calcium channel blockers and tricyclics have been controversial and should not take precedence over traditional management. LIPAEMIC record show improved results as Glasgow coma scale, hemodynamic variables and survival. Conclusion: There is no way to predict the response to lipid therapy nor the consequences, and that's why until this day it should not replace any treatment that the physician considers appropriate for the management of his patient
Keywords : Lipid emulsion therapy; Toxicology; Local anesthetic toxicity; Lipid therapy toxicology; Lipid sink.