Intravenous Lipid Emulsion as Antidote: Experience in Hong Kong

Objective: Intravenous lipid emulsion (ILE) is an emerging therapy in the field of toxicology. The purpose of this study was to report the accumulated local experience on using ILE in the management of patients suffering from poisoning by pharmaceutical agents other than local anaesthetics. Design: Case series. Setting: Local poison information centre. Methods: Ten patients were identified from the database of Hong Kong Poison Information Centre. The patients were managed in 6 Hong Kong public hospitals during a 4-year study period (July 2008-June 2012). Results: Nine of them presented with drug-induced cardiotoxicity, defined as either cardiac arrest (n=3) or hypotension refractory to other treatments (n=6). The overall survival rate is 30%. Possible adverse events from ILE included mild derangement of liver function, elevated amylase and hyperlipidaemia were observed. Conclusions: About 30% of severe poison-induced cardiotoxicity treated with ILE can survive with no major adverse effects. The use of ILE remains to be a treatment option for lipid-soluble drug induced severe toxicity not responsive to standard resuscitation measures.