Unit:
ΠΜΣ Καρδιοαναπνευστική ΑναζωογόνησηLibrary of the School of Health Sciences
Author:
Psychalakis Nikolaos
Supervisors info:
Νικολέττα Ιακωβίδου, Αναπληρώτρια Καθηγήτρια Παιδιατρικής - Νεογνολογίας, Ιατρικής Σχολής, Πανεπιστημίου Αθηνών
Θεόδωρος Ξάνθος, Καθηγητής Παθοφυσιολογίας, Ιατρικής Σχολής, Ευρωπαϊκού Πανεπιστημίου Κύπρου
Γεώργιο Γκιόκας, Αναπληρωτής Καθηγητής Χειρουργικής Εντατικής Θεραπείας, Ιατρικής Σχολής, Πανεπιστημίου Αθηνών
Original Title:
Επίδραση γαλακτώδους διαλύματος στην επιβίωση σε χοίρειο πρότυπο υπερδοσολογίας αμιοδαρόνης
Summary:
Aim: Intralipid® (ILE) is well known for its binding effect on lipophilic drugs. Amiodarone, a lipophilic drug, is a potent anti-arrhythmic with potential serious adverse effects, one of which is hypotension. The aim of the present study was to investigate whether a lipid emulsion could counteract the hypotensive effects of amiodarone overdose after an acute intravenous administration, in an established model of swine cardiovascular research, and whether it could improve 4h-survival.
Methods: Twenty pigs were intubated and instrumented to measure aortic pressures, central venous pressures (CVP). Cardiac rhythm and heart rate was monitored by electrocardiography. After allowing the animals to stabilize for 60 minutes, amiodarone overdose (1 mg/kg/min) was initiated for a maximum of 20 minutes. Afterwards, the animals were randomized into 2 groups. Group A (n=10) received 0.9% Normal Saline (NS) and Group B (n=10) received 20% ILE. A bolus dose of 2 ml/kg in over 2 min time was initially administered in both groups followed by a 45min infusion (0.2 ml/kg/min) of either NS or ILE. All animals were monitored invasively for 4 hours and after the end of the experiment they were humanely euthanized.
Results: All animals received the overdose of amioradone for 20 minutes. All animals survived the overdose and all animals survived the monitoring period of 4 hours. ILE infusion had a varying effect on hemodynamic and metabolic parameters. The main action was evident at 2 min after ILE infusion and was maintained for 15 minutes in the ILE receiving group. Moreover, animals that received ILE had higher CVP, an effect which was attenuated at 2 and 4 hours post administration. Animals that received ILE were more acidotic in the monitoring period compared to animals that received NS.
Conclusion: In this swine model of amiodarone toxicity, ILE attenuated the hypotensive effects of amiodarone toxicity for a period of 15 minutes compared to animals receiving NS.
Keywords:
Effect
Intralipid
Overdose
Amiodarone
Number of references:
165
