What is the clinical evidence from this study?

Study design: Editorial. Population: Local Anesthetic Systemic Toxicity (LAST). Intervention: Intravenous lipid emulsions (ILE). Primary outcome: Survival rates.

February 1, 2019Anesthesia & Analgesia

Tuning Up the Life Saver: An Experimental Approach to Optimizing the Delivery of Intravenous Lipid Emulsions

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Key result

In a rat model of bupivacaine toxicity, central continuous infusion (80%) and peripheral bolus injections (73%) of lipid emulsion yielded higher survival than peripheral continuous infusion (20%).

Why the study?

Does the locus and mode of intravenous lipid emulsion delivery improve survival in rats with bupivacaine toxicity?

Structured PICO

Does the locus and mode of intravenous lipid emulsion delivery improve survival in rats with bupivacaine toxicity?

Population

Rats with intentional bupivacaine toxicity (0.2% bupivacaine administered via femoral vein to rapidly reach 20 mg/kg, leading to asystole)

Intervention

20% intravenous lipid emulsion (ILE) delivered via central (internal jugular) continuous infusion, peripheral (tail vein) continuous infusion, or peripheral (tail vein) bolus injections

Comparator

The three delivery regimens were compared against each other

Outcome

Survival rate and return of heartbeat at 40 minuteshard clinical

Limitations

Use of the rodent heart, which is too small to allow the long cardiac conduction pathway that enables the circus rhythms that are a common cause of ventricular fibrillations.
Use of the rodent heart, which is too small to allow the long cardiac conduction pathway that enables the circus rhythms that are a common cause of ventricular fibrillations

Discussion

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Implication

Central continuous infusion or peripheral bolus injections of lipid emulsion appear more effective than peripheral continuous infusion for reversing bupivacaine-induced asystole in a rat model.

Cite This Study

Zeballos et al. (2019) conducted an editorial in Local Anesthetic Systemic Toxicity (LAST). Intravenous lipid emulsions (ILE) was evaluated on Survival rates. In a rat model of bupivacaine toxicity, central continuous infusion (80%) and peripheral bolus injections (73%) of lipid emulsion yielded higher survival than peripheral continuous infusion (20%).

synapsesocial.com/papers/6a92af426724a03bc54f487a https://doi.org/10.1213/ane.0000000000003863

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Implication

Central continuous infusion or peripheral bolus injections of lipid emulsion appear more effective than peripheral continuous infusion for reversing bupivacaine-induced asystole in a rat model.

Tuning Up the Life Saver: An Experimental Approach to Optimizing the Delivery of Intravenous Lipid Emulsions

Structured PICO

Limitations

Discussion

Implication

Cite This Study

Tuning Up the Life Saver: An Experimental Approach to Optimizing the Delivery of Intravenous Lipid Emulsions

Structured PICO

Limitations

Discussion

Implication

Cite This Study

Also Consider

Also Consider