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Are manifestations of CNS toxicity a plausible heralding feature of potential cardiotoxicity? If so, would it be prudent to prophylactically bolus with 1.5cc/kg of 20% intralipids to conceivably avert cardiovascular manifestations?
February 22, 2010 | Unregistered CommenterP. Gloersen, M.D.
Good question, Dr. G. I think it is best left to the judgement ofthe treating physician who will undoubtedly have the best feel for the potential severity and rate of progression of the toxicity. I don't believe any sort of algorithm can reliably predict the risk benefit of giving lipid early for this patient. There are certainly several case reports of patients given lipid very early where the doctor believed a catastrophe was averted...presumably based on the rapidity of accumulating signs of toxicity. The shorter answer to your question is, 'yes' giving lipid can probably prevent progression....but the definitive answer will differ for each patient. Only the person with eyes on the field will have a good idea when it's reasona ble to give lipid.
February 23, 2010 | Registered Commenter[Guy Weinberg]