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A MOST AMAZING CASE!

I am very happy to record the publication of a remarkable case report. First author, Dr. A. Sirianni, was the attending anesthesiologist who recommended 20% lipid emulsion infusion for treatment of a young patient in cardiac arrest following an overdose of bupropion. She had been pulseless for more than an hour, and blood pressure and ECG werer unresponsive or minimally responsive to maximal adrenergic and bicarbonate therapy. Archie had been consulted for airway and access issues and in contemplating what else he could add, made the connection between an overdose with a drug having some sodium channel blocking properties, to the case report he'd read several months before by Meg Rosenblatt, who in turn had been familiar with lipidrescue and published the first report of its successful use. Back to Archie: he called home, got his wife to read Meg's case report, ran to the pharmacy to pick up the lipid, sprinted back to the ICU and made a suggestion. There'd been no substantive improvement in the patient's condition, so the Code Blue team was receptive. Within one minute of the lipid infusion, pulses returned, and CPR was stopped. The patient quickly regained normal vital signs and ECG. She has subsequently recovered without neurological deficit, is attending school, and I hear, getting good grades. Though I was not there, except in spirit, I still consider this by far the most exciting case I've ever had the privilege to be associated with- albeit by at least two degrees of (published) separation. It is truly amazing. Please read this article.....it's worth it. This is what I call real translational work. Wow. Good work Archie. You've definitely logged some heaven insurance.  

Posted on Thursday, September 13, 2007 at 08:06PM by Registered Commenter[Guy Weinberg] | Comments2 Comments

Reader Comments (2)

Does anyone have information on using lipid rescue in pediatric patients?
November 5, 2007 | Unregistered CommenterJulie Lasseigne
hi julie,
the bupropion case was in a 17 yo, who fortunately survived to see her 18th birthday in the hospital. she's now home, doing well in school. i can tell you of a 13 year old successfully resuscitated in France. this very impressive case report was presented as an abstract at the ASA in SF this year. they have excellent ecg strips showing resolution of the ventricular arrhythmias with lipid. it will be published in the near future. that is my only knowledge of younger patients. please let us know if you're aware of any others.
thanks for the question:
guy
November 6, 2007 | Registered Commenter[Guy Weinberg]

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