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药物中毒

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脂肪乳治疗-新的证据
原作者: Fermin Barrueto,肖锋译 文章来源: 《中华急诊医学杂志》编辑部 发布日期:2013-06-14

Title: Lipid Emulsion Therapy - Increasing Evidence
题目:脂肪乳治疗-新的证据
Author作者: FerminBarrueto

Utilizing 20% lipid emulsion at a dose of 1.5 mL/kg (100 mL Bolus) IV with repeat in 15 minutes in no response is being recommended in patients hemodynamic instabiity due to poisoning.
在抢救血流动力学不稳定中毒患者时,可用1.5毫升/公斤(100毫静推)20%的脂肪乳剂,如没有反应可在15分钟内按同样剂量重复一次。
Probably more effective in lipophilic drugs is a current theory for the mechanism of action - the "lipid sink". The idea is that the lipids envelope the drug pulling it off its receptors or sequestering it in the intravascular space. A recent paper has added another mechanism - direct inotropic and lusiptropic effects.(1)
对亲脂性药物更有效可能是其作用机理 - “脂肪沉淀”。这个机制是脂质将药物包裹使其与药物受体分离或沉淀在血管内间隙。最近的一篇论文谈到了另外一个机制 - 直接的肌力增强效果。
Also, if you think the therapy is experimental, think again. Another recent paper surveyed Poison Control Centers and found 30/45 Poison Centers in the US have a defined protocol for utilization of lipid emulsion therapy. The PCCs are recommending it more.(2)
另外,如果你认为这种治疗还是处于实验阶段,多思考一下。另一个最近的一篇论文对美国毒物控制中心进行了调查,发现美国30/45毒物中心有一个明确的使用脂肪乳方案。 美国毒物控制中心越来越推荐它的使用。
What was once considered just a purely experimental therapy only used at the very end of code is becoming more mainstream. Comfort with its safety profile and effiicacy continues to mount.
一个曾经被认为只是用于抢救末期的实验性治疗,将成为主要的抢救手段。对其安全性和效果的认知会继续增加。
References
Fettiplace MR, Ripper R, Lis K, Lin B, Lang J, Zider B, Wang J,
Rubinstein I, Weinberg G. Rapid Cardiotonic Effects of Lipid Emulsion
Infusion. Crit Care Med. 2013 Mar 25. [Epub ahead of print]


Christian MR, Pallasch EM, Wahl M, Mycyk MB. Lipid Rescue 911: Are
Poison Centers Recommending Intravenous Fat Emulsion Therapy for
Severe Poisoning? J Med Toxicol. 2013 May 10. [Epub ahead of print]
 

文章来源:《中华急诊医学杂志》编辑部