Intravenous fat emulsion therapy: can it be tried without sufficient first-line treatment modalities?

摘要

I read with interest the study performed by Livshits and colleagues entitled 'Life-threatening bupropion ingestion: is there a role for intravenous fat emulsion?' recently published in Basic Clin Pharmacol Toxicol [1]. They presented a 51-year-old woman brought to the hospital after two tonic-clomc convulsions at home. Since the patient had a suspected diagnosis of diphenhydramine toxicity, a widened QRS complex (which had at first narrowed with intravenous administration of hypertonic sodium bicarbonate), and a hypotension refractory to the authors' treatment, intravenous fat emulsion (IFE) was recommended. It seems that the patient recovered after two boluses and one infusion of IFE. Although an interesting study, there are some concerns rising about the management of this patient.