Gómez-Ramírez LA, Baena-Gallego F, Torres-Zapata A, Montoya-Zapata LM, Berrouet-Mejía MC

Language: Spanish
References: 19
Page: 175-179
PDF size: 242.84 Kb.

ABSTRACT

Background: severe poisonings by lipophilic substances represent a therapeutic challenge in emergency settings. Lipid emulsions (LE) are formulations of triglycerides and phospholipids that have gained relevance as a rescue therapy. Their key mechanism of action is the lipid sink effect (lipid sequestration) complemented by metabolic effects and the modulation of ion channels, offering cardiovascular and neurological benefits.
Case Presentation: this series describes two adult patients poisoned by multiple lipophilic medications (antidepressants, antipsychotics, anticonvulsants, or beta-blockers). Both cases presented with severe cardiovascular and neurological toxicity (e.g., complex arrhythmias, status epilepticus) refractory to supportive measures and conventional pharmacological therapies.
Results: following the standardized administration of 20% lipid emulsions, both patients showed a significant hemodynamic (e.g., arrhythmia reversal) and neurological (e.g., seizure cessation) improvement. Both cases had a favorable clinical outcome, with complete resolution of the acute toxicity.
Conclusions: the administration of lipid emulsions proved to be a useful rescue therapy in patients with severe toxicity from non-anesthetic xenobiotics refractory to initial management. Its use, although based on low-quality evidence, should be reserved for scenarios

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