Abstract | BACKGROUND: OBJECTIVE: This review aims to identify recent literature on the use of ILE in humans as an antidote and to familiarize emergency providers with the indications, availability, dosing recommendations, and adverse reactions associated with ILE use. METHODS: A systemic literature search of MEDLINE, EMBASE, and major toxicology conference abstracts was performed for human cases using ILE as an antidote with documented clinical outcomes through January 2014. RESULTS: DISCUSSION: No standard of care is defined for the use of ILE, although the American Heart Association recommends use in LAST, and the American College of Medical Toxicology recommends consideration for circumstances of hemodynamic instability resultant from lipid-soluble xenobiotics. ILE should be administered per American Society of Regional Anesthesia and Pain Medicine dosing recommendations. Laboratory interference, pancreatitis, respiratory distress syndrome, and interference with vasopressors should be considered as risks but are uncommon. CONCLUSIONS: In the setting of severe hemodynamic compromise by lipid-soluble xenobiotics, ILE may be considered for resuscitation by emergency physicians. As such, ILE may be stocked in emergency departments in close proximity to resuscitation rooms and areas where local nerve blocks are performed.
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Authors | Dazhe Cao, Kennon Heard, Mark Foran, Alex Koyfman |
Journal | The Journal of emergency medicine
(J Emerg Med)
Vol. 48
Issue 3
Pg. 387-97
(Mar 2015)
ISSN: 0736-4679 [Print] United States |
PMID | 25534900
(Publication Type: Case Reports, Journal Article, Review, Systematic Review)
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Copyright | Copyright © 2015 Elsevier Inc. All rights reserved. |
Chemical References |
- Anesthetics, Local
- Anti-Arrhythmia Agents
- Antidepressive Agents, Tricyclic
- Antidotes
- Fat Emulsions, Intravenous
- Verapamil
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Topics |
- Adult
- Anesthetics, Local
(poisoning)
- Anti-Arrhythmia Agents
(poisoning)
- Antidepressive Agents, Tricyclic
(poisoning)
- Antidotes
(therapeutic use)
- Emergency Service, Hospital
- Fat Emulsions, Intravenous
(therapeutic use)
- Female
- Humans
- Poisoning
(therapy)
- Practice Guidelines as Topic
- Verapamil
(poisoning)
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