Journal of Medical Toxicology

, Volume 10, Issue 2, pp 133–142

LIPAEMIC Report: Results of Clinical Use of Intravenous Lipid Emulsion in Drug Toxicity Reported to an Online Lipid Registry

  • Grant Cave
  • Martyn Harvey
  • Johann Willers
  • David Uncles
  • Tim Meek
  • John Picard
  • Guy Weinberg
Toxicology Investigation

DOI: 10.1007/s13181-013-0375-y

Cite this article as:
Cave, G., Harvey, M., Willers, J. et al. J. Med. Toxicol. (2014) 10: 133. doi:10.1007/s13181-013-0375-y

Abstract

The use of intravenous lipid emulsion (ILE) as an antidote has prompted significant academic and clinical interest. Between August 2009 and August 2012, data from cases of ILE use in intoxicated patients in different hospitals on different continents were voluntarily entered into a registry based on the world wide web (www.lipidregistry.org). Here, we report data from this project. Participating centers were given access to the registry following institutional subscription. Specifically sought were details of the individual patients’ presenting condition, indications for ILE use, ILE administration regimen, potential complications, and of clinical outcome. Forty-eight uses of ILE were reported from 61 participating centers. Ten cases of local anesthetic systemic toxicity were reported; all (10/10) survived. Thirty-eight cases of intoxication by other agents were reported [30 decreased conscious state, 8 cardiovascular collapse (3 deaths)]. There was an elevation in GCS (p < 0.0001) and increased systolic blood pressure (p = 0.012) from immediately prior to ILE administration to 30 min after use. One serious and two minor adverse effects of ILE use were recorded in 48 reported cases (one case of bronchospastic reaction, one case of hyperamylasemia and one case of interference with laboratory testing). In this series of cases reported to the registry, improvements were seen for GCS in patients with central nervous system toxicity and in systolic blood pressure in shocked patients over a short time frame after the injection of ILE. Few adverse effects were recorded. Clinical trials and the reporting of drug concentrations after ILE use are necessary to further elucidate the role of ILE in clinical toxicology.

Keywords

Lipid emulsionRegistryAntidotePoisoning

Supplementary material

13181_2013_375_MOESM1_ESM.pdf (376 kb)
Esm 1(PDF 376 kb)

Copyright information

© American College of Medical Toxicology 2014

Authors and Affiliations

  • Grant Cave
    • 1
  • Martyn Harvey
    • 2
  • Johann Willers
    • 3
  • David Uncles
    • 3
  • Tim Meek
    • 4
  • John Picard
    • 5
  • Guy Weinberg
    • 6
  1. 1.Department of Critical CareTamworth Rural Referral HospitalTamworthAustralia
  2. 2.Waikato DHB Emergency DepartmentHamiltonNew Zealand
  3. 3.Department of Anaesthesia and Intensive Care, Western Sussex Hospital NHS TrustWorthing HospitalWorthingUK
  4. 4.South Tees Hospital NHS TrustMiddlesboroughUK
  5. 5.Imperial College NHS TrustLondonUK
  6. 6.University of Illinois College of MedicineChicagoUSA