University of Rochester Medical Center , Rochester, NY , USA.
Clin Toxicol (Phila). 2013 Nov;51(9):896-8. doi: 10.3109/15563650.2013.831436. Epub 2013 Aug 30.
Lipid emulsion is gaining popularity as an antidote for lipophilic drug overdose, and is generally considered safe at doses recommended for antidotal therapy. We report a case of asymptomatic pancreatitis following extended infusion lipid emulsion.
A 14-year-old female presented to the emergency department actively seizing after ingesting 9 g of bupropion and unknown amounts of hydroxyzine and citalopram. She was intubated for airway protection, and gastrointestinal decontamination was performed with activated charcoal. She was treated with potassium and magnesium for a prolonged QT interval and sodium bicarbonate for metabolic acidosis and QRS complex widening. Upon transfer to the pediatric intensive care unit, she seized again, became hypotensive, and developed a junctional cardiac rhythm. A lipid emulsion bolus was recommended which improved her hypotension and conduction abnormalities. The lipid emulsion was continued for several hours and she received a total dose of 46 mL/kg in less than 12 h. She developed lipemia, which interfered with laboratory analysis, a severe elevation in her triglycerides, as well as a mild pancreatitis that resolved over several days, although she was asymptomatic.
Large doses of lipid emulsion may result in lipemia, severe hypertriglyceridemia, interference in laboratory analyses, and pancreatitis. This is the third reported adverse event due to lipid emulsion therapy used for overdose.
脂肪乳作为一种亲脂性药物中毒的解毒剂越来越受欢迎，并且在推荐的解毒治疗剂量下通常被认为是安全的。我们报告了一例在延长输注脂肪乳后无症状性胰腺炎的病例。
一名 14 岁女性因摄入 9 克安非他酮和未知量的羟嗪和西酞普兰后出现癫痫发作而被紧急送往急诊科。她因气道保护而被插管，并使用活性炭进行胃肠去污。她因 QT 间期延长接受了钾和镁治疗，因代谢性酸中毒和 QRS 复合波增宽接受了碳酸氢钠治疗。在转入儿科重症监护病房时，她再次发作，出现低血压，并出现交界性心律失常。建议使用脂肪乳剂推注，这改善了她的低血压和传导异常。脂肪乳剂继续输注数小时，在不到 12 小时内她共接受了 46 毫升/公斤的剂量。她出现脂血症，这干扰了实验室分析，甘油三酯严重升高，以及轻度胰腺炎，尽管她无症状，但在数天内得到缓解。
大剂量的脂肪乳剂可能导致脂血症、严重的高甘油三酯血症、实验室分析干扰和胰腺炎。这是第三例因过量使用脂肪乳剂治疗而导致的不良事件报告。
