RESUMO
Intravenous lipid emulsion (ILE) therapy is a novel treatment that was discovered in the last decade. Despite unclear understanding of its mechanisms of action, numerous and diverse publications attested to its clinical use. However, current evidence supporting its use is unclear and recommendations are inconsistent. To assist clinicians in decision-making, the American Academy of Clinical Toxicology created a workgroup composed of international experts from various clinical specialties, which includes representatives of major clinical toxicology associations. Rigorous methodology using the Appraisal of Guidelines for Research and Evaluation or AGREE II instrument was developed to provide a framework for the systematic reviews for this project and to formulate evidence-based recommendations on the use of ILE in poisoning. Systematic reviews on the efficacy of ILE in local anesthetic toxicity and non-local anesthetic poisonings as well as adverse effects of ILE are planned. A comprehensive review of lipid analytical interferences and a survey of ILE costs will be developed. The evidence will be appraised using the GRADE system. A thorough and transparent process for consensus statements will be performed to provide recommendations, using a modified Delphi method with two rounds of voting. This process will allow for the production of useful practice recommendations for this therapy.(AU)
Assuntos
Humanos , Intoxicação/tratamento farmacológico , Emulsões Gordurosas Intravenosas/administração & dosagem , Anestésicos Locais/administração & dosagem , Antídotos/administração & dosagemAssuntos
Intoxicação/epidemiologia , Intoxicação/mortalidade , Adolescente , Criança , Pré-Escolar , Bases de Dados Factuais , Drogas Desenhadas/intoxicação , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Centros de Controle de Intoxicações , Transtornos Relacionados ao Uso de Substâncias/mortalidade , Suicídio/estatística & dados numéricos , Estados Unidos/epidemiologiaAssuntos
Bases de Dados Factuais , Exposição Ambiental , Centros de Controle de Intoxicações/estatística & dados numéricos , Intoxicação/mortalidade , Adolescente , Causas de Morte , Criança , Pré-Escolar , Exposição Ambiental/efeitos adversos , Exposição Ambiental/estatística & dados numéricos , Humanos , Lactente , Vigilância da População , Estados Unidos/epidemiologiaRESUMO
Isopropanol, a known central nervous system depressant has been reported to cause toxicity via multiple routes including ingestion, inhalation and dermal exposure. We present a case of transplacental isopropanol exposure in a neonate. A woman reported polysubstance abuse in the 1 to 2 days before precipitously delivering a newborn infant. The neonate developed hypotension, hypotonia and seizure activity within the first few hours of life. Blood samples from the infant revealed toxic levels of isopropanol. Similar symptoms have been reported in infants with isopropanol toxicity from other routes of exposure.
