LipidRescue™ Resuscitation

A 50 yo male patient admitted with poly-drug overdose (spironolactone, chlordiazepoxide, temazepam, levothyroxine, and suspected calcium channel blocker). The patient experienced three episodes of arrest, necessitating CPR and intubation. Flumazenil was administered with no significant improvement. IV fluids, as well as norepinephrine, dopamine, and eventually vasopressin were all administered concurrently at maximum rates. Despite the fluids and pressors, the patient failed to maintain normotension. An attempt to use glucagon, then D50W and insulin drip failed to yield significant improvments. Per recommendation from the poison control center given to the attending physician, a trial of 20% fat emulsion (1.5 mL/kg load over 1 minute and 0.25 mL/kg continuous infusion) was initiated. The load was given two times, approximately 5 minutes apart, and the continuous infusion was at a rate of 1000 mL/hr due to IV pump limitations. After the second bolus, the attending provider was contacted and elected to stop the lipid infusion since no immediate improvement was noted. The patient eventually improved, was extubated, and discharged from the hospital.