Comparison of Methods for Intravenous Infusion of Fat Emulsion During Extracorporeal Membrane Oxygenation

Buck, Marcia L.; Wooldridge, Peggy; Ksenich, Roberta A.

doi:10.1592/phco.2005.25.11.1536

Cited by 27 publications

(24 citation statements)

References 11 publications

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“…There are suggestions that concomitant infusion of ILE with VA-ECMO could result in fat emulsion agglutination, malfunction of the membrane oxygenator and increased risk of blood clot formation 88. These complications were seen in at least one in vitro study89 and one observational study,90 although two case reports reported no such problems 91 92. An additional seven case reports made no specific comments of any complications 93–99.…”

Section: Discussionmentioning

confidence: 99%

Pharmacological and mechanical management of calcium channel blocker toxicity

Fadhlillah¹,

Patil

2018

BMJ Case Reports

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Cardiovascular instability associated with calcium channel blocker toxicity comprises a small percentage of overdose presentations, yet they are associated with a high mortality rate. We detail the management of a 64-year-old man who took an intentional overdose of 840 mg nimodipine. We include the treatment he received and highlight the scarcity of evidence behind the use of gastric decontamination, calcium, glucagon, intravenous lipid emulsion, high-dose insulin therapy, sodium bicarbonate, vasopressors and methylene blue in calcium channel blocker toxicity. Additionally, the article explores the use of electrical pacing and venoarterial extracorporeal membrane oxygenation (VA-ECMO). Following successful weaning of VA-ECMO, the patient was successfully extubated but remained neurologically impaired due to hypoxic-ischaemic brain injury, critical care polyneuropathy and renal failure requiring dialysis. He has cerebral performance category 3; he has mild cognitive impairment but able to perform some activities of daily living independently and communicate his thoughts and needs. He requires no respiratory or cardiovascular support.

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Section: Discussionmentioning

confidence: 99%

Pharmacological and mechanical management of calcium channel blocker toxicity

Fadhlillah¹,

Patil

2018

BMJ Case Reports

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“…The infusion of intravenous fat emulsion in patients on ECMO has been reported to cause agglutination in the ECMO circuit, though none was noted in this case. 24 …”

Section: Discussionmentioning

confidence: 99%

Venoarterial extracorporeal membrane oxygenation for the management of massive amlodipine overdose

et al. 2013

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A 50-year-old man was admitted to the intensive care unit with respiratory failure and shock after suffering a massive overdose of amlodipine, lisinopril and hydrochlorothiazide. Despite mechanical ventilation, vasopressors, calcium gluconate, hyperinsulinemia-euglycemia therapy, methylene blue and intravenous fat emulsion, the patient's respiratory and hemodynamic status deteriorated. Venoarterial extracorporeal membrane oxygenation (ECMO) was initiated to provide cardiopulmonary support in the setting of profound respiratory failure and refractory shock. The patient was placed on ECMO 19 hours after arrival to the hospital, after which vasopressor and ventilatory requirements decreased significantly. The patient was decannulated from ECMO after 8 days and was discharged home after a 56-day hospitalization. Early institution of ECMO should be considered for the management of respiratory failure and refractory shock in the setting of calcium channel blocker overdose when medical therapies are insufficient.

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“…Concerns remain about appropriate methods of administration of ILE to prevent layering, agglutination, and clotting in areas of flow stasis in the circuit . A very small, prospective study of neonatal ECLS patients was conducted comparing infusion of ILE through the ECLS circuit to infusion via a separate, peripheral IV . The authors describe increased incidences of clotting, as well as layering and agglutination in the ECLS circuit, when ILE is infused into the ECLS circuit directly and suggest that separate IV access be used to administer ILE whenever possible.…”

Section: Nutrition Delivery Routementioning

confidence: 99%

“…21 A very small, prospective study of neonatal ECLS patients was conducted comparing infusion of ILE through the ECLS circuit to infusion via a separate, peripheral IV. 22 The authors describe increased incidences of clotting, as well as layering and agglutination in the ECLS circuit, when ILE is infused into the ECLS circuit directly and suggest that separate IV access be used to administer ILE whenever possible. Further, they suggest that the layering and agglutination noted when ILE is infused through the ECLS circuit may result in impaired delivery of energy, although there were no significant differences in triglyceride levels between groups.…”

Section: Nutrition Delivery Routementioning

confidence: 99%

Neonatal Extracorporeal Life Support: A Review of Nutrition Considerations

2018

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Critically ill neonates who require extracorporeal life support have particular nutrition needs. These infants require prescription of aggressive, early nutrition support by knowledge providers. Understanding the unique metabolic demands and nutrition requirements of these fragile patients is paramount, particularly if additional therapies such as aggressive diuretic regimens or continuous renal replacement therapy are used concurrently. Although the American Society for Parenteral and Enteral Nutrition has published guidelines for this population, a review of each nutrition component is warranted because few studies exist specific to this population. Long-term complications in survivors of neonatal extracorporeal life support, particularly in patients with select diagnoses such as congenital diaphragmatic hernia, can be significant and must be recognized and anticipated. This review focuses on recognizing the nutrition needs of neonatal patients requiring extracorporeal life support, appraising the available data to guide selection of an appropriate mode of nutrition delivery, and describing the anticipated long-term nutrition implications of extracorporeal life support provision during the neonatal period.

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Comparison of Methods for Intravenous Infusion of Fat Emulsion During Extracorporeal Membrane Oxygenation

Cited by 27 publications

References 11 publications

Pharmacological and mechanical management of calcium channel blocker toxicity

Pharmacological and mechanical management of calcium channel blocker toxicity

Venoarterial extracorporeal membrane oxygenation for the management of massive amlodipine overdose

Neonatal Extracorporeal Life Support: A Review of Nutrition Considerations

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