LipidRescue™ Resuscitation

This is a great question, Anny. I have given this issue a lot of consideration over the years and though the risks of giving lipid infusion are minimal, I would reserve that for a patient exhibiting symptoms or signs of toxicity. Exceptions where pre-emptive lipid infusion makes sense would be where a patient was inadvertently given an overdose of bupivacaine (ie pediatric patient gets adult dose) or a bupivacaine Bier block (ie student draws up the wrong drug). Before symptoms appear or the tourniquet is let down, an infusion of lipid would appear logical to me. HOwever, note that the hafl life of hypertriglyceridemia, (a marker for lipid effect) is only ~14min. Therefore, since we can't predict when toxicity will usually occur, giving lipid to a patient at high risk, but otherwise standard of care, might be mis-timed.
let me know if i answered your questions.
G