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Comparison of Intravenous Lipid Emulsion, Bicarbonate, and Tailored Liposomes in Rabbit Clomipramine Toxicity
Author(s) -
Cave Grant,
Harvey Martyn,
Shaw Tom,
Damitz Robert,
Chauhan Anuj
Publication year - 2013
Publication title -
academic emergency medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.221
H-Index - 124
eISSN - 1553-2712
pISSN - 1069-6563
DOI - 10.1111/acem.12224
Subject(s) - medicine , toxicity , anesthesia , interquartile range , clomipramine , sodium bicarbonate , pharmacology , surgery , chemistry
Objectives Liposome ( LIP )‐like lipid dispersions have emerged as useful detoxification vehicles in vitro. The authors compare resuscitation with tailored LIP s, 20% intravenous lipid emulsion ( ILE ), and sodium bicarbonate ( BIC ), in a rabbit model of clomipramine toxicity. Methods Sedated, instrumented New Zealand white rabbits underwent clomipramine infusion at 3.2 mg/kg/min to 50% baseline mean arterial pressure (MAP) and then at 1.6 mg/kg/min for 30 minutes. BIC (3 mL /kg 8.4%), ILE (3 mL /kg 20%), or LIP (24 mg/kg) were infused as rescue treatments at toxicity and were repeated at 10 minutes ( n = 5 in each group). Results Thirty‐minute MAP was greatest in ILE ‐treated animals: 61 mm Hg ILE (interquartile range [ IQR ] = 49 to 64 mm Hg), 43 mm Hg LIP ( IQR = 36.5 to 49 mm Hg), and 10 mm Hg BIC ( IQR = 10 to 44 mm Hg; all p = 0.02). Two of the five BIC ‐treated animals survived to 30 minutes, compared with all five of the ILE ‐treated animals and all five of the LIP ‐treated animals (p = 0.044). Conclusions Both ILE and LIP s improved hemodynamic recovery compared with bicarbonate in clomipramine‐induced cardiotoxicity in rabbits. Greater 30‐minute MAP was observed in the ILE group.