The Use of Dye Surrogates to Illustrate Local Anesthetic Drug Sequestration by Lipid Emulsion

Papadopoulou, Aikaterini; Willers, Johann; Samuels, T. L.; Uncles, D. R.

doi:10.1097/aap.0b013e318244b2b7

Cited by 16 publications

(10 citation statements)

References 26 publications

(18 reference statements)

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“…Essentially, lipid therapy expands the lipid compartment within the intravascular space which draws tissue bound drug off cellular receptor sites and into plasma, thereby trapping it in the transiently expanded lipid phase . The lipid sink theory was demonstrated in a study using a dye surrogate to visualize local anesthetic sequestration by lipid emulsion . More recently, the static “lipid sink” model has been refined into a dynamic “lipid shuttle/subway.” This description takes into account the redistribution of a xenobiotic molecule from target tissue and shuttling it to a less threatening location for storage, metabolism, and/or excretion .…”

Section: Discussionmentioning

confidence: 99%

“…17 The lipid sink theory was demonstrated in a study using a dye surrogate to visualize local anesthetic sequestration by lipid emulsion. 18 More recently, the static "lipid sink" model has been refined into a dynamic "lipid shuttle/subway." This description takes into account the redistribution of a xenobiotic molecule from target tissue and shuttling it to a less threatening location for storage, metabolism, and/or excretion.…”

Section: Discussionmentioning

confidence: 99%

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Use of intravenous lipid therapy in a cat with carprofen overdose

Chumbler

Schildt

Mawby

et al. 2020

Clinical Case Reports

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Use of intravenous lipid therapy in a cat with carprofen overdose

Chumbler

Schildt

Mawby

et al. 2020

Clinical Case Reports

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show abstract

“…Papadopoulou A et al [12] hypothesized that by substituting a dye surrogate in place of local anesthetic, they could visually demonstrate dye sequestration by lipid emulsion that would be dependent on both dye lipophilicity and the amount of lipid emulsion used.…”

Section: The Intralipid Sink Effectmentioning

confidence: 99%

Can intralipid infusion open a coronary occlusion causing acute myocardial infarction?

Eldor¹

2017

Clin Med Invest

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Coronary heart disease remains the leading cause of morbidity and mortality in Western countries. The best hope of salvaging viable myocardium after a coronary occlusion is by rapid reperfusion of the ischemic myocardium, either by thrombolysis or primary percutaneous coronary intervention. The use of intravenous intralipid infusion instead of thrombolysis or primary percutaneous coronary intervention is first suggested in the medical literature.Correspondence to: Joseph Eldor, Theoretical Medicine Institute, Jerusalem, Israel, E-mail: csen_international@csen.com Key words: intralipid, myocardial infarction, coronary occlusionReceived: June 18, 2017; Accepted: July 15, 2017; Published: July 17, 2017 Thrombolysis or primary percutaneous coronary intervention or Intralipid Infusion?Coronary heart disease remains the leading cause of morbidity and mortality in Western countries. The best hope of salvaging viable myocardium after a coronary occlusion is by rapid reperfusion of the ischemic myocardium, either by thrombolysis or primary percutaneous coronary intervention. Although reperfusion restores blood flow, oxygen, and nutrients to the cardiac muscle, it also has the potential to induce reperfusion injury.Postconditioning of the heart with brief episodes of reperfusion/ occlusion at the onset of reflow has been shown to limit infarct size. However, this approach is not practical for patients treated with thrombolytic agents and therefore a more generic pharmacologic postconditioning is still needed. The ideal pharmacologic candidates need to be safe and effective when administered during the first few minutes of reperfusion by inducing cellular protection or enhancing myocardial tolerance to ischemia/reperfusion injury. Several drugs have yielded encouraging results in animals and a few have been tested in humans; however, none of these modalities has been widely accepted.Lipids and in particular polyunsaturated fatty acids have received special cardiovascular research attention because polyunsaturated fatty acid-rich diets are associated with a decreased risk of coronary artery disease. Acute application of polyunsaturated fatty acids to cardiomyocytes has also been shown to shorten action potential duration and this could account for the antiarrhythmic mechanism of the polyunsaturated fatty acids. Intralipid (Sigma, St. Louis, MO) is a brand name for the first safe fat emulsion for human use; Intralipid 20% is an emulsion of soybean oil (20%), egg yolk phospholipids (1.2%), and glycerol (2.2%). Intralipid has been widely used in patients who need total parenteral nutrition and as a vehicle for different drugs such as propofol. It has been shown recently that postischemic administration of Intralipid protects the isolated rat heart against ischemia/reperfusion injury. However, the molecular mechanism in which Intralipid mediates cardioprotection is completely unknown [1].Intralipid, a brand name for the first safe fat emulsion for human use, has been shown to be cardioprotective. However, the mechanism ...

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“…Papadopoulou A et al, [8] hypothesized that by substituting a dye surrogate in place of local anesthetic, they could visually demonstrate dye sequestration by lipid emulsion that would be dependent on both dye lipophilicity and the amount of lipid emulsion used.…”

Section: The Lipid Sink Effectmentioning

confidence: 99%

Intralipid treatment: Is it only the tip of an iceberg? A new suggestion: Bone cement implantation syndrome (BCIS)

Eldor¹,

Kotlovker²

2012

J Anesthesiol Clin Sci

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On 1998 it was first showed that intravenous intralipid could prevent or improve resuscitation from cardiovascular collapse by severe bupivacaine overdose in rats. Since then published examples now include toxicities related to verapamil, diltiazem, amlodipine, quetiapine and sertraline, haldoperidol, lamotrigine, olanzapine, propranolol, atenolol, nevibolol, doxepin, dosulepin, imipramine, amitriptyline, glyosphate herbicide, flecainide, venlafaxine, moxidectin, and others. Intralipid treatment is a new treatment for Bone cement implantation syndrome (BCIS) which was never suggested before. Animal studies should be done in order to evaluate this new treatment modality.

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The Use of Dye Surrogates to Illustrate Local Anesthetic Drug Sequestration by Lipid Emulsion

Abstract: Our study provides a visual demonstration of the lipid sink effect. It supports the theory that lipid emulsion may reduce the amount of free drug present in plasma from concentrations associated with an invariably fatal outcome to those that are potentially survivable.

Cited by 16 publications

References 26 publications

Use of intravenous lipid therapy in a cat with carprofen overdose

Use of intravenous lipid therapy in a cat with carprofen overdose

Can intralipid infusion open a coronary occlusion causing acute myocardial infarction?

Intralipid treatment: Is it only the tip of an iceberg? A new suggestion: Bone cement implantation syndrome (BCIS)

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