Syndrome de surcharge en lipides : un accident iatrogène rare

Picón, Juan Ignacio Robles; Carsin, Anne-Elie; Baravalle‐Einaudi, M.; Coste, Maylis; Wasier, A.-P.; Bel, N. Stremler‐Le; Bosdure, E.; Dubus, J.‐C.

doi:10.1016/j.arcped.2016.05.011

Cited by 3 publications

(2 citation statements)

References 16 publications

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“…He rapidly presented a deterioration of the general condition with fever (39 °C), sweating, polypnoea, desaturation and acute respiratory distress, requiring transfer to a paediatric intensive care unit to provide respiratory support. The severe hypertriglyceridemia and the overall condition improved after 10 days [ 40 ].…”

Section: Discussionmentioning

confidence: 99%

Fatal accidental lipid overdose with intravenous composite lipid emulsion in a premature newborn: a case report

et al. 2021

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Background Tenfold or more overdose of a drug or preparation is a dreadful adverse event in neonatology, often due to an error in programming the infusion pump flow rate. Lipid overdose is exceptional in this context and has never been reported during the administration of a composite intravenous lipid emulsion (ILE). Case presentation Twenty-four hours after birth, a 30 weeks’ gestation infant with a birthweight of 930 g inadvertently received 28 ml of a composite ILE over 4 h. The ILE contained 50% medium-chain triglycerides and 50% soybean oil, corresponding to 6 g/kg of lipids (25 mg/kg/min). The patient developed acute respiratory distress with echocardiographic markers of pulmonary hypertension and was treated with inhaled nitric oxide and high-frequency oscillatory ventilation. Serum triglyceride level peaked at 51.4 g/L, 17 h after the lipid overload. Triple-volume exchange transfusion was performed twice, decreasing the triglyceride concentration to < 10 g/L. The infant’s condition remained critical, with persistent bleeding and shock despite supportive treatment and peritoneal dialysis. Death occurred 69 h after the overdose in a context of refractory lactic acidosis. Conclusions Massive ILE overdose is life-threatening in the early neonatal period, particularly in premature and hypotrophic infants. This case highlights the vigilance required when ILEs are administered separately from other parenteral intakes. Exchange transfusion should be considered at the first signs of clinical or biological worsening to avoid progression to multiple organ failure.

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Section: Discussionmentioning

confidence: 99%

Fatal accidental lipid overdose with intravenous composite lipid emulsion in a premature newborn: a case report

et al. 2021

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“…Clinically, ILE has caused fat overload syndrome in older. The reasons may be related to decline in body function and a decreased ability to clear fat (90,91). In addition, the amount of lipid emulsion should be carefully considered in patients with lipid metabolism and storage disorders (38).…”

Section: What To Pay Attention To When Using Lipid Emulsionmentioning

confidence: 99%

Mechanisms and Efficacy of Intravenous Lipid Emulsion Treatment for Systemic Toxicity From Local Anesthetics

Liu

Zhang

et al. 2021

Front. Med.

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Local anesthetics are widely used clinically for perioperative analgesia to achieve comfort in medical treatment. However, when the concentration of local anesthetics in the blood exceeds the tolerance of the body, local anesthetic systemic toxicity (LAST) will occur. With the development and popularization of positioning technology under direct ultrasound, the risks and cases of LAST associated with direct entry of the anesthetic into the blood vessel have been reduced. Clinical occurrence of LAST usually presents as a series of severe toxic reactions such as myocardial depression, which is life-threatening. In addition to basic life support (airway management, advanced cardiac life support, etc.), intravenous lipid emulsion (ILE) has been introduced as a treatment option in recent years and has gradually become the first-line treatment for LAST. This review introduces the mechanisms of LAST and identifies the clinical symptoms displayed by the central nervous system and cardiovascular system. The paper features the multimodal mechanism of LAST reversal by ILE, describes research progress in the field, and identifies other anesthetics involved in the resuscitation process of LAST. Finally, the review presents key issues in lipid therapy. Although ILE has achieved notable success in the treatment of LAST, adverse reactions and contraindications also exist; therefore, ILE requires a high degree of attention during use. More in-depth research on the treatment mechanism of ILE, the resuscitation dosage and method of ILE, and the combined use with other resuscitation measures is needed to improve the efficacy and safety of clinical resuscitation after LAST in the future.

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Lipid emulsion overdose

2016

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Syndrome de surcharge en lipides : un accident iatrogène rare

Cited by 3 publications

References 16 publications

Fatal accidental lipid overdose with intravenous composite lipid emulsion in a premature newborn: a case report

Fatal accidental lipid overdose with intravenous composite lipid emulsion in a premature newborn: a case report

Mechanisms and Efficacy of Intravenous Lipid Emulsion Treatment for Systemic Toxicity From Local Anesthetics

Lipid emulsion overdose

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