Lipid resuscitation in acute poisoning: after a decade of publications, what have we really learned?.

Purpose of review: The decision to provide intravenous lipid emulsion (ILE) therapy as a treatment modality for the reversal of various drug toxicity was discovered in the last decade. Numerous publications, in both human and animals attested to its clinical use, but current supporting evidence supporting inconsistent. Recent findings: A recent systematic review reported evidence for benefit of ILE in bupivacaine toxicity. Human randomized trials and large observational studies as well as animal models of orogastric poisoning failed to report a clear benefit of ILE for nonlocal anesthetics poisoning. Summary: ILE can be used to resuscitate local anesthetics especially bupivacaine. The impact of ILE on oral overdoses is controversial and clear evidence on benefit is lacking. A thorough risk benefit assessment with consideration of alternative options is warranted to minimize the risk of adverse effects. Evidence supports using bolus doses of ILE, while infusion rates are still debatable Copyright (C) 2017 YEAR Wolters Kluwer Health, Inc. All rights reserved.

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