Veterinary Clinic for Small Animals, Tierklinik Hofheim, Tierärzte IVC Evidensia GmbH, Hofheim am Taunus, Hessen, Germany.
LMU Small Animal Clinic, LMU München, München, Germany.
PLoS One. 2024 May 29;19(5):e0298828. doi: 10.1371/journal.pone.0298828. eCollection 2024.
This retrospective study aimed to evaluate the effects on the clinical signs of poisoning and adverse effects of intravenous lipid emulsion treatment in 82 animals (dogs and cats) with suspected poisonings over 18 months. Physical examination parameters and state of consciousness were documented every hour after the intravenous administration of a bolus of 2 ml/kg and 0.25 ml/kg/min over 60 minutes of a 20% intravenous lipid emulsion. The modified Glasgow coma scale and laboratory findings (blood gas analysis, triglyceride, lactate) were evaluated initially and three hours after discontinuing intravenous lipid emulsion administration. A statistical evaluation of the occurrence of adverse effects and the development of laboratory values was performed. A decrease in respiratory rate in the second control (8-12 hours) after ILE was observed. Three hours after completing of the intravenous lipid emulsion, triglyceride concentration increased about 10 times (p <0.001). Venous carbon dioxide partial pressure, bicarbonate, base excess, as well as the electrolytes sodium, potassium and ionized calcium decreased significantly (p <0.001). Patients who experienced a worsening of the modified Glasgow coma scale had a higher increase in triglyceride concentrations (p = 0.041) and plasma lactate (p = 0.034) and a larger decrease in bicarbonate concentrations (p = 0.053) compared to others. About 54% (n = 44) of the patients showed adverse effects which could be attributed to the administration of intravenous lipid emulsion and may be associated with a higher triglyceride increase. All of them were completely reversible within 33 hours. Adverse effects associated with intravenous lipid emulsion therapy were observed in half of the patients and were associated with a higher increase in triglycerides.
本回顾性研究旨在评估在 18 个月内对 82 例(犬和猫)疑似中毒动物进行静脉内脂肪乳剂治疗对中毒临床症状和不良反应的影响。在 60 分钟内静脉输注 20%静脉内脂肪乳剂 2ml/kg 和 0.25ml/kg/min 的推注后,每小时记录体格检查参数和意识状态。最初和停止静脉内脂肪乳剂输注后 3 小时评估改良格拉斯哥昏迷量表和实验室检查结果(血气分析、甘油三酯、乳酸)。对不良反应的发生和实验室值的发展进行了统计学评估。在 ILE 后第二个对照(8-12 小时)中观察到呼吸频率下降。在完成静脉内脂肪乳剂输注后 3 小时,甘油三酯浓度增加了约 10 倍(p<0.001)。静脉血二氧化碳分压、碳酸氢盐、碱剩余以及电解质钠、钾和离子钙显著降低(p<0.001)。改良格拉斯哥昏迷量表恶化的患者甘油三酯浓度(p=0.041)和血浆乳酸(p=0.034)升高幅度更大,碳酸氢盐浓度降低幅度更大(p=0.053)。与其他患者相比,约 54%(n=44)的患者出现不良反应,这些不良反应可能与静脉内脂肪乳剂的给予有关,并且可能与甘油三酯升高有关。所有患者在 33 小时内完全逆转。在一半的患者中观察到与静脉内脂肪乳剂治疗相关的不良反应,并且与甘油三酯升高有关。