Intralipid

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General

Adult Dosing

  • 1.5 ml/kg bolus[1]
    • Followed by 0.25 ml/kg/min for 20 min or until hemodynamic stability is achieved.[2]

Pediatric Dosing

Special Populations

Contraindications

  • Allergy to class/drug

Adverse Reactions

Serious

  • Asystole (case reported) [3]
  • Fat embolism
  • Hypersensitivity reactions

Common

  • Pancreatitis[4]
  • Hypertriglyceridemia[4]
  • Interferes with some lab measurements
    • Glucose and magnesium concentrations become inaccurate
    • Creatinine and lipase become unmeasurable

Pharmacology

  • Half-life:
  • Metabolism:
  • Excretion:
  • Mechanism of Action:
    • Emulsion acts as a “lipid sink,” surrounding a lipophilic drug molecule and rendering it ineffective
    • Fatty acids from the ILE provide the myocardium with a ready energy source, improving cardiac function

Comments

See Also

External Links

References

  1. Cave, G. Intravenous Lipid Emulsion as Antidote Beyond Local Anesthetic Toxicity: A Systematic Review. 2009. 16(9)815–824
  2. Dillane D, Finucane BT. Local anesthetic systemic toxicity. Can J Anaesth. 2010 Apr;57(4):368-80.
  3. Cole JB et al. Asystole immediately following intravenous fat emulsion for overdose. J Med Toxicol. 2014;10(3)307-310
  4. 4.0 4.1 Kostic MA and Gorelick M. Review of the use of lipid emulsion in nonlocal anesthetic poisoning. Pediatric Emergency Care 2014;30:427-436