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Review
. 2012 Jul;117(1):180-7.
doi: 10.1097/ALN.0b013e31825ad8de.

Lipid emulsion infusion: resuscitation for local anesthetic and other drug overdose

Guy L Weinberg  1
Affiliations
Review

Lipid emulsion infusion: resuscitation for local anesthetic and other drug overdose

Guy L Weinberg. Anesthesiology. 2012 Jul.
No abstract available

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Figures

Figure 1
Figure 1
Proposed mechanisms of lipid resuscitation. After infusion, the lipid emulsion exists in the blood as emulsified oil droplets or multi-lamellar vesicles which for the sake of simplicity are represented as micelles. 1. Capture of LA (lipid sink); 2. Increased fatty acid uptake by mitochondria (metabolic effect); 3. Inteference with LA binding of sodium channels (membrane effect); 4. Activation of Akt cascade leading to inhibition of GSK-3beta (cytoprotection); 5. Promotion of calcium entry via voltage-dependent calcium channels (ionotropic/inotropic; can also involve mitochondrial calcium dynamics); 6. Accelerated shunting (pharmacokinetic effects). FFA: free fatty acids; LA: local anesthetic; Cn: carnitine; FA-Cn: fatty acyl carnitine; Na: sodium ion; Ca: calcium ion; Akt: a serine/threonine protein kinase important in cell survival, proliferation and migration (also called Protein Kinase B); GSK-3beta: glycogen synthase kinase (phophorylates and thereby inhibits glycogen synthase; inhibition of GSK-3beta has been implicated in preventing myocardial ischemia-reperfusion injury).
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References

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