Ask Us > CPR post lipid administration - How long?
Hi Becky,
I think reasonable limits to lipid emulsion infusion are:
~10-12 mL/kg (lean or ideal body mass). our approximation of a safe upper dose limit
10 min after successful resuscitation: to lower the likelihood of recurrent clinical toxicity
30 min total
Let us know how your patient did. Note that virtually every reported successful lipid rescue was in the context of a witnessed arrest, meaning that intervention/resuscitation was not delayed and tissue hypoperfusion/acidosis/hyperlactatemia were minimized, thereby giving lipid infusion the best chance to work. We have no data (good or bad) with the use of lipid in out of hospital arrest, but I would surmise that lipid might not make as big a difference in this contact as in the witnessed arrest and early infusion. As you may know, there is also a question abotu the aggressive use of epinephrine and other pressors that we believe are injurious to the patient (despite the tangible bias of an elevated blood pressure) and almost certainly impair lipid rescue. Finally, I would also point out that some toxicities are presumably just too overwhelming for anything to work.
I think reasonable limits to lipid emulsion infusion are:
~10-12 mL/kg (lean or ideal body mass). our approximation of a safe upper dose limit
10 min after successful resuscitation: to lower the likelihood of recurrent clinical toxicity
30 min total
Let us know how your patient did. Note that virtually every reported successful lipid rescue was in the context of a witnessed arrest, meaning that intervention/resuscitation was not delayed and tissue hypoperfusion/acidosis/hyperlactatemia were minimized, thereby giving lipid infusion the best chance to work. We have no data (good or bad) with the use of lipid in out of hospital arrest, but I would surmise that lipid might not make as big a difference in this contact as in the witnessed arrest and early infusion. As you may know, there is also a question abotu the aggressive use of epinephrine and other pressors that we believe are injurious to the patient (despite the tangible bias of an elevated blood pressure) and almost certainly impair lipid rescue. Finally, I would also point out that some toxicities are presumably just too overwhelming for anything to work.
July 4, 2012 |
[Guy Weinberg]
[Guy Weinberg]
Is there any guidance on this?
Thanks