Premium
Hemodynamic Effects of Intravenous, High‐Dose Lipid Emulsion With and Without Metoprolol Infusion in Healthy Volunteers: A Randomized Clinical Trial
Author(s) -
Petersen Kasper Meidahl,
Bøgevig Søren,
Petersen Tonny Studsgaard,
Jensen Thomas Bo,
Dalhoff Kim Peder,
Henriksen Trine,
Poulsen Henrik Enghusen,
Christensen Mikkel Bring
Publication year - 2019
Publication title -
clinical pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.941
H-Index - 188
eISSN - 1532-6535
pISSN - 0009-9236
DOI - 10.1002/cpt.1281
Subject(s) - metoprolol , medicine , placebo , hemodynamics , anesthesia , crossover study , bolus (digestion) , randomized controlled trial , heart rate , confidence interval , adverse effect , blood pressure , alternative medicine , pathology
In a double‐blinded, randomized, crossover trial, we investigated the hemodynamic effects of high‐dose intravenous lipid emulsion ( ILE ) with/without metoprolol. Ten healthy volunteers each completed 4 trial days (placebo + ILE ; metoprolol + placebo; metoprolol + ILE ; placebo + placebo) in random order. Metoprolol was administered as an initial bolus (10 mg), followed by an infusion (50 mg) from 5 to 30 minutes. ILE was administered as a bolus at 12.5 minutes (2.5 mL/kg), followed by a 15‐minute infusion (0.25 mL/kg per minute). On metoprolol + ILE days (compared with metoprolol + placebo) after 120 minutes, mean heart rates were significantly higher (difference, 5.5 beats per minute (bpm); 95% confidence interval ( CI) , 3.0–8.1 bpm; P < 0.001), and average relative cardiac output was higher (difference, 10 percentage points; 95% CI , 5–15 percentage points; P < 0.001). The hemodynamic effect of ILE developed gradually. ILE had no effect on plasma metoprolol or major adverse events. In conclusion, high‐dose ILE has relatively marginal and delayed hemodynamic effects that may have limited clinical relevance in the short‐term clinical toxicological setting.