Intralipid therapy does not improve level of consciousness in overdoses with sedating drugs: a case series.

Abstract

Objective: To assess the effect of intralipid emulsion therapy (ILE) in sedating drugs presenting to an urban emergency department. Methods: Following the introduction of a clinical protocol for the use of ILE a retrospective chart review was undertaken, which describes the use of ILE in treating sedating drug overdose in a facility with a tertiary referral level clinical toxicology unit. Demographic data as well as details of drug ingested, physiological parameters and disposition were extracted from the medical record. Results: Over a 7 month period nine cases were treated with intralipid, of which two were male and the median age was 33 years (17–52 years). Endotracheal intubation was required in seven cases and of the other two, one required a nasopharyngeal airway for several hours while being observed in a critical care area. One patient was managed in the intensive care unit without intubation. The median duration of ventilation in the seven patients was 31 h (22–82 h), and median length of stay for all nine cases was 63 h (24–133 h). Conclusion:This study does not support any clinically significant effect of intralipid in sedating drug overdose