![]() ![]() ![]() Weinberg- redistribution and metabolism of Lipid emulsion-Bupivacaine/toxic agent complex to the liver.Įghbali group demonstrated that post-ischemic treatment with Intralipid prevents the opening of mitochondrial permeability transition pore and protects the heart through glycogen synthase kinase-3 β. ![]() The lower part of the figure shows accelerated-Shuttel Effect term used by Dr. The adjacent blood vessel highlights scavenging effect and Lipid Sink theory which removes Bupivacaine/Toxic agents through Lipid emulsion. The upper figure shows unknown probable Intracellular effects of Lipid emulsion. 5įigure 1 A hypothetical mechanism of actions for Lipid emulsion. They suggested ROS as active cardioprotective metabolite of Intralipid. 4 Lou et al., 5 evaluated the Mechanism of Intralipid-Mediated Cardioprotection and concluded that active metabolite, Palmitoylcarnitine, Generates Reactive Oxygen Species (ROS) and Activates Reperfusion Injury Salvage Kinases. 3 Intralipid was used successfully to treat the refractory hypotension following epidural anaesthesia. 2 Rat and dog studies showed that lipid emulsions could be used in establishing normal sinus rhythm and maintaining oxygenation after Bupivacaine-induced arrest. They showed that Lipid treatment accelerates recovery from Bupivacaine-induced asystole in the isolated rat heart, reduces Bupivacaine content, and increases cardiac Bupivacaine washout. 1 Although Lipid Sink theory was the primary theory for mechanism of action but couple of different theories have come to the table to discuss ( Figure 1). Weinberg as an effective treatment for reversing cardiotoxicity due to local anesthetics. In this review some of the novel applications of Intralipid have introduced. Intralipid and other balanced lipid emulsions provide essential fatty acids. The 30% concentration has not been approved for direct intravenous infusion. Intralipid is an emulsion of soy bean oil, egg phospholipids and glycerin, and is available in 10%, 20% and 30% concentrations. Intralipid has been used as a source of energy and essential fatty acids for parenteral nutrition. Since identification of lipid resuscitation therapy in 1998 as a treatment for LA toxicity by Weinberg, 1 many studies and experiments have been performed in order to explore more the mechanism of this novel treatment. With appearing more evidences for intralipid different applications there is a hope that many types of drug-induced CNS or cardiac toxicities could be treated by Lipid Rescue effect as a safe treatment option. Reportedly lipid infusion was successful in reversing neurological signs of toxicity from local anesthetics. The first case report of successful Lipid Rescue was published in 2006. Weinberg began working on the effects of local anesthetics and discovered that an infusion of lipid emulsion not only protect against but also correct local anesthetic cardiac toxicity. In recent papers many different applications of Intralipid or oil containing products-Lipid Emulsion-have successfully experimented in critical care patients. Intravenous lipid emulsion therapy was introduced as a treatment for local anesthetic toxicity it has shown couple of reversing and therapeutic efficacies for a number of different drug toxicities. ![]()
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