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Am J Emerg Med. 2016 Aug;34(8):1389-93. doi: 10.1016/j.ajem.2016.04.001. Epub 2016 Apr 4.

Intralipid™ administration attenuates the hypotensive effects of acute intravenous amiodarone overdose in a swine model.

Author information

1
European University Cyprus, School of Medicine, Nicosia, Cyprus; Hellenic Society of Cardiopulmonary Resuscitation, Athens, Greece.
2
Experimental - Research Center ELPEN, Athens, Greece.
3
Cardiff Metropolitan University, Cardiff, UK.
4
General Hospital of Nikaia, 3rd Department of Internal Medicine, Athens, Greece.
5
Avesta Hospital, Avesta Health Center, Avesta, Sweden.
6
National and Kapodistrian University of Athens, Medical School, Aretaieion University Hospital, 2nd Department of Surgery.
7
Hellenic Society of Cardiopulmonary Resuscitation, Athens, Greece; National and Kapodistrian University of Athens, Medical School, Postgraduate Study Program (MSc) "Cardiopulmonary Resuscitation", Athens, Greece. Electronic address: thanoschalkias@yahoo.gr.
8
Hellenic Society of Cardiopulmonary Resuscitation, Athens, Greece; National and Kapodistrian University of Athens, Medical School, Postgraduate Study Program (MSc) "Cardiopulmonary Resuscitation", Athens, Greece.

Abstract

PURPOSE:

To investigate whether a lipid emulsion could counteract the hypotensive effects of amiodarone overdose after an acute intravenous administration and improve 4 h survival in an established model of swine cardiovascular research.

METHODS:

Twenty pigs were intubated and instrumented to measure aortic pressures and central venous pressures (CVP). After allowing the animals to stabilize for 60 minutes, amiodarone overdose (1 mg/kg/min) was initiated for a maximum of 20 minutes. Afterwards, the animals were randomized into 2 groups. Group A (n = 10) received 0.9% Normal Saline (NS) and Group B (n = 10) received 20% Intralipid® (ILE). A bolus dose of 2 ml/kg in over 2 min time was initially administered in both groups followed by a 45 min infusion (0.2 ml/kg/min) of either NS or ILE.

RESULTS:

All animals survived the overdose and all animals survived the monitoring period of 4 hours. Systolic aortic pressure (SpthAorta) (6.90 vs 14.10 mmHg, P = .006) and mean arterial pressure (MAP) (6.10 vs 14.90 mmHg, P = .001) were higher in the ILE group 2 min after the bolus ILE infusion. This difference was maintained for 15 min after ILE infusion for both SpthAorta (7.85 vs 13.15 mmHg, P = .044) and MAP (7.85 vs 13.15 mmHg, P = .042). Animals that received ILE had higher CVP (11.6 vs 15.7 mmHg, P = .046), an effect which was attenuated 2 and 4 hours post administration. Animals receiving ILE were more acidotic (7.21 vs 7.38, P = .048) in the monitoring period compared to animals receiving NS.

CONCLUSIONS:

Intralipid attenuated the hypotensive effects of amiodarone toxicity for a period of 15 minutes compared to animals receiving NS.

PMID:
27131633
DOI:
10.1016/j.ajem.2016.04.001
[Indexed for MEDLINE]

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