Lipid Emulsion Therapy in Lipophilic or Hydrophilic Drug Intoxication: The Last Weapon in Our Arsenal

For the first time in 1998, the infusion of soybean oil used in total parenteral nutrition solutions showed that it could prevent cardiovascular collapse resulting from an overdose of bupivacaine in anesthetized rats and could improve resuscitation (1). In another experimental model, spontaneous circulation was restored in all lipid-treated animals following a bupivacaine challenge, but it was not restored in any of the saline-treated control subjects (2). The first case report describing the use of intravenous lipid emulsion (ILE) therapy as a rescue or antidotal therapy for acute intoxication was published in 2006 (3). In recent years, it has become one of the most recommended treatment methods for patients who have experienced cardiac arrest or those with high hemodynamic risk following xenobiotic toxicity (4).