Use of Intravenous Fat Emulsion in the Emergency Department for the Critically Ill Poisoned Patient

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• 作者：Samuel H.F. Lam ; MD^&lowast ; ; ; Nima Majlesi ; DO^&dagger ; ; Gary M. Vilke ; MD^&lowast ;
• 关键词：intravenous fat emulsion ; poisoned patient ; review
• 刊名：Journal of Emergency Medicine
• 出版年：2016
• 出版时间：August 2016
• 年：2016
• 卷：51
• 期：2
• 页码：203-214
• 全文大小：252 K

文摘

Multiple case reports of using intravenous fat emulsion (IFE) as an antidote for human poisoning from various xenobiotics have been published over the last decade. Given the rapidly evolving field, emergency physicians may be uncertain about the indications, timing, and dose for IFE treatment.

bsSec_2">Methods

bspara0015">A PubMed literature search was conducted from January 1996 to November 2015 and limited to human studies written in English and articles with relevant keywords. Guideline statements and nonsystematic reviews were excluded. Studies identified then underwent a structured review of their results.

bsSec_3">Results

bspara0020">There were 986 papers fulfilling the search criteria screened, and 85 appropriate articles were rigorously reviewed in detail. Recommendations were given on indications, timing, and dose of IFE. Most of these were based on case reports and anecdotal experience.

bsSec_4">Discussion

bspara0025">In critically ill patients with refractory shock or cardiac arrest after a suspected overdose of local anesthetics or selected xenobiotics, IFE may be considered as a potentially beneficial adjunctive treatment. Despite an abundance of reports on the use of IFE on xenobiotics poisoning, the quality of evidence is suboptimal and fraught with reporting bias.

bsSec_5">Conclusions

bspara0030">IFE may be an effective antidote in poisonings from various xenobiotics. However, further research is needed to determine its optimal circumstances, timing, and dose of use.