Intralipid therapy does not improve level of consciousness in overdoses with sedating drugs: a case series

Emerg Med Australas. 2014 Jun;26(3):286-90. doi: 10.1111/1742-6723.12237. Epub 2014 May 8.

Abstract

Objective: To assess the effect of intralipid emulsion therapy (ILE) in sedating drugs presenting to an urban emergency department.

Methods: Following the introduction of a clinical protocol for the use of ILE a retrospective chart review was undertaken, which describes the use of ILE in treating sedating drug overdose in a facility with a tertiary referral level clinical toxicology unit. Demographic data as well as details of drug ingested, physiological parameters and disposition were extracted from the medical record.

Results: Over a 7 month period nine cases were treated with intralipid, of which two were male and the median age was 33 years (17-52 years). Endotracheal intubation was required in seven cases and of the other two, one required a nasopharyngeal airway for several hours while being observed in a critical care area. One patient was managed in the intensive care unit without intubation. The median duration of ventilation in the seven patients was 31 h (22-82 h), and median length of stay for all nine cases was 63 h (24-133 h).

Conclusion: This study does not support any clinically significant effect of intralipid in sedating drug overdose.

Keywords: intravenous; lipid emulsion; poisoning.

MeSH terms

  • Adolescent
  • Adult
  • Airway Management / methods
  • Consciousness / drug effects*
  • Drug Overdose / drug therapy*
  • Emergency Service, Hospital
  • Emulsions / administration & dosage
  • Fat Emulsions, Intravenous / administration & dosage*
  • Female
  • Glasgow Coma Scale
  • Hospitals, Urban
  • Humans
  • Hypnotics and Sedatives / poisoning*
  • Length of Stay
  • Male
  • Middle Aged
  • Phospholipids / administration & dosage*
  • Retrospective Studies
  • Soybean Oil / administration & dosage*
  • Young Adult

Substances

  • Emulsions
  • Fat Emulsions, Intravenous
  • Hypnotics and Sedatives
  • Phospholipids
  • soybean oil, phospholipid emulsion
  • Soybean Oil