Lipid therapy in oral poisoning: a not-so-systematic review

2 out of 5 stars No support for lipid rescue in oral poisoning: A systematic review and analysis of 160 published cases. Forsberg M et al. Hum Exp Toxicol 2016 Nov 24 [Epub ahead of print] Abstract The authors’ goal was “to present a systematic review and case analysis of practically all published reports on humans treated with lipid rescue for LAST [local anesthetic systemic toxicity] or oral poisoning.” The focus of the paper is on oral poisonings. The authors report that they identified 94 reported cases of oral poisoning with “alleged” positive response to lipid rescue therapy (LRT.) Two authors reviewed each case and rated causality (that is, LRT -> positive response) using a modified WHO-UMC scale. (As the authors note, the WHO-UMC scale was actually designed to determine causality in adverse drug reactions, not antidote response.) If the two authors disagreed as to the causality score, “consensus was obtained through discussion.” The authors report that all 94 oral poisonings received scores of 2 (probable causality,) 3 (possible causality,) and 4 (unlikely causality.) in fact, 86% received a score of 3 or 4. They note that 91% of these cases received other treatment modalities at approximately the same time they received LRT. The authors conclude: “Considering the findings of the present study, the weak and contradictory scientific evidence for lipid rescue being an effective antidote and its increasingly reported adv...
Source: The Poison Review - Category: Toxicology Authors: Tags: Medical intralipid intravenous lipid emulsion lipid rescue therapy systematic review Source Type: news