Cave Grant, Harvey Martyn G
Crit Care. 2014 Jul 30;18(5):457. doi: 10.1186/s13054-014-0457-5.
The use of intravenous lipid emulsions (ILEs) as antidote in local anaesthetic systemic toxicity has gained widespread support following convincing data from animal models, and successful case reports in humans. Proposed beneficial mechanisms of action for ILEs include intravascular sequestration of intoxicant and subsequent enhanced redistribution to biologically inert tissues, augmentation of fatty acid utilisation for ATP synthesis in the context of metabolic poisoning, and direct cardiotonic and ion channel effects. The evidence base for use of ILEs in acute drug intoxication is evolving. The present evidence supports use of ILEs only in local anaesthetic systemic toxicity and in lipophilic cardiotoxin intoxication when there is an immediate threat to life, and other therapies have proven ineffective.
在动物模型获得令人信服的数据以及人类成功的病例报告之后，静脉注射脂质乳剂（ILEs）作为局部麻醉药全身毒性的解毒剂已获得广泛支持。ILEs提出的有益作用机制包括血管内隔离毒物并随后增强其向生物惰性组织的再分布，在代谢中毒的情况下增加脂肪酸用于ATP合成的利用率，以及直接的强心和离子通道效应。ILEs用于急性药物中毒的证据基础正在不断发展。目前的证据支持仅在对生命有直接威胁且其他治疗已证明无效时，将ILEs用于局部麻醉药全身毒性和亲脂性心脏毒素中毒。
