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Intravenous Lipid Emulsion Alters the Hemodynamic Response to Epinephrine in a Rat Model

  • Toxicology Investigation
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Abstract

Intravenous lipid emulsion (ILE) is an adjunctive antidote used in selected critically ill poisoned patients. These patients may also require administration of advanced cardiac life support (ACLS) drugs. Limited data is available to describe interactions of ILE with standard ACLS drugs, specifically epinephrine. Twenty rats with intra-arterial and intravenous access were sedated with isoflurane and split into ILE or normal saline (NS) pretreatment groups. All received epinephrine 15 μm/kg intravenously (IV). Continuous mean arterial pressure (MAP) and heart rate (HR) were monitored until both indices returned to baseline. Standardized t tests were used to compare peak MAP, time to peak MAP, maximum change in HR, time to maximum change in HR, and time to return to baseline MAP/HR. There was a significant difference (p = 0.023) in time to peak MAP in the ILE group (54 s, 95 % CI 44–64) versus the NS group (40 s, 95 % CI 32–48) and a significant difference (p = 0.004) in time to return to baseline MAP in ILE group (171 s, 95 % CI 148–194) versus NS group (130 s, 95 % CI 113–147). There were no significant differences in the peak change in MAP, peak change in HR, time to minimum HR, or time to return to baseline HR between groups. ILE-pretreated rats had a significant difference in MAP response to epinephrine; ILE delayed the peak effect and prolonged the duration of effect of epinephrine on MAP, but did not alter the peak increase in MAP or the HR response.

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Acknowledgments

Funding for the study was generously provided by University Emergency Medicine Foundation via a resident scholarly development grant. Support for study logistics was provided by Dr. Francesca Beaudoin. Statistical support was provided by Dr. Jason Machan. Evelyn Tolbert, Dr. Lance Dworkin, and Scott McAllister provided procedural training and technical assistance.

Funding Source

University Emergency Medicine Foundation resident scholarly development grant

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Authors and Affiliations

  1. Department of Emergency Medicine, The Alpert Medical School, Brown University, Providence, RI, USA

    Stephanie Carreiro, Jared Blum, Gregory Jay & Jason B. Hack

  2. Division of Medical Toxicology, The Alpert Medical School, Brown University, Providence, RI, USA

    Jason B. Hack

  3. Department of Emergency Medicine, Rhode Island Hospital, 593 Eddy Street, Claverick 274, Providence, RI, 02903, USA

    Stephanie Carreiro

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  1. Stephanie Carreiro
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  2. Jared Blum
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  4. Jason B. Hack
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Correspondence to Stephanie Carreiro.

Additional information

This data was presented in abstract form at the New England Regional Society of Academic Emergency Medicine Conference, Springfield, MA, USA on March 21, 2012 and the Society of Academic Emergency Medicine 2012 Annual Meeting, Chicago, IL, USA on May 12, 2012.

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Carreiro, S., Blum, J., Jay, G. et al. Intravenous Lipid Emulsion Alters the Hemodynamic Response to Epinephrine in a Rat Model. J. Med. Toxicol. 9, 220–225 (2013). https://doi.org/10.1007/s13181-013-0291-1

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  • DOI: https://doi.org/10.1007/s13181-013-0291-1

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