Journal article
Lipid emulsion improves survival in animal models of local anesthetic toxicity: a meta-analysis
Clinical toxicology (Philadelphia, Pa.), Vol.55(7), pp.617-623
08/09/2017
DOI: 10.1080/15563650.2017.1288911
PMID: 28346007
Abstract
Introduction: The Lipid Emulsion Therapy workgroup, organized by the American Academy of Clinical Toxicology, recently conducted a systematic review, which subjectively evaluated lipid emulsion as a treatment for local anesthetic toxicity. We re-extracted data and conducted a meta-analysis of survival in animal models.
Methods: We extracted survival data from 26 publications and conducted a random-effect meta-analysis based on odds ratio weighted by inverse variance. We assessed the benefit of lipid emulsion as an independent variable in resuscitative models (16 studies). We measured Cochran's Q for heterogeneity and I
2
to determine variance contributed by heterogeneity. Finally, we conducted a funnel plot analysis and Egger's test to assess for publication bias in studies.
Results: Lipid emulsion reduced the odds of death in resuscitative models (OR =0.24; 95%CI: 0.1-0.56, p = .0012). Heterogeneity analysis indicated a homogenous distribution. Funnel plot analysis did not indicate publication bias in experimental models.
Discussion: Meta-analysis of animal data supports the use of lipid emulsion (in combination with other resuscitative measures) for the treatment of local anesthetic toxicity, specifically from bupivacaine. Our conclusion differed from the original review. Analysis of outliers reinforced the need for good life support measures (securement of airway and chest compressions) along with prompt treatment with lipid.
Details
- Title: Subtitle
- Lipid emulsion improves survival in animal models of local anesthetic toxicity: a meta-analysis
- Creators
- Michael R. Fettiplace - University of Illinois ChicagoDaniel J. McCabe - John H. Stroger, Jr. Hospital of Cook County
- Resource Type
- Journal article
- Publication Details
- Clinical toxicology (Philadelphia, Pa.), Vol.55(7), pp.617-623
- DOI
- 10.1080/15563650.2017.1288911
- PMID
- 28346007
- NLM abbreviation
- Clin Toxicol (Phila)
- ISSN
- 1556-3650
- eISSN
- 1556-9519
- Publisher
- Taylor & Francis
- Grant note
- University of Illinois College of Medicine 86-09S1 / NIH
- Language
- English
- Date published
- 08/09/2017
- Academic Unit
- Emergency Medicine
- Record Identifier
- 9984297142002771
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