Although the mechanism of action is not well known, intravenous lipid emulsion (ILE) has been shown to be effective in the treatment of lipophilic drug intoxications. It is thought that, ILE probably separates the lipophilic drugs from target tissue by creating a lipid-rich compartment in the plasma. The second theory is that ILE provides energy to myocardium with high-dose free fatty acids activating the voltage-gated calcium channels in the myocytes. In this study, effects of ILE treatment on digoxin overdose were searched in an animal model in terms of cardiac side effects and survival. Forty Sprague-Dawley rats were divided into five groups. As the pre-treatment, the groups were administered saline, ILE, DigiFab and DigiFab and ILE. Following that, digoxin was infused to all groups until death except the control group. First arrhythmia and cardiac arrest observation times were recorded. According to the results, there was no statistically significant difference among the group in terms of first arrhythmia time and cardiac arrest times. However, when the saline group compared with ILE-treated group separately, significant difference was observed. DigiFab, ILE or ILE-DigiFab treatment make no significant difference in terms of the first arrhythmia and cardiac arrest duration in digoxin-intoxicated rats. However, it is not possible to say that at the given doses, ILE treatment might be successful at least as a known antidote. The fact that the statistical significance between the two groups is not observed in the subgroup analysis, the study should be repeated with larger groups.
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http://dx.doi.org/10.1007/s12012-018-9444-4 | DOI Listing |
J Am Acad Orthop Surg Glob Res Rev
January 2025
From the Department of Orthopaedic Surgery, Singapore General Hospital, Singapore (Dr. Loh, Dr. Ling, Dr. Jiang, and Lim) and the Department of Surgical Intensive Care, Division of Anaesthesiology and Perioperative Medicine, Singapore General Hospital, Singapore (Dr. Goh).
We report a case of pulseless electrical activity (PEA) associated with profound hypermagnesemia immediately after cementation of a novel magnesium-based cement in spine surgery. During T8 to T12 posterior instrumentation and decompression laminectomy for vertebral metastasis secondary to lung cancer, a 61-year-old Chinese woman developed sudden hypotension and went into PEA immediately after injection of a novel magnesium-based cement. Intraoperative fluoroscopic imaging did not show any notable cement extravasation.
View Article and Find Full Text PDFJ Artif Organs
January 2025
Department of Anesthesiology and Critical Care Medicine, Hokkaido University Faculty of Medicine, Sapporo, Japan.
We tested the hypothesis that disseminated intravascular coagulation (DIC) predicts a poor prognosis in patients with out-of-hospital cardiac arrest (OHCA) treated with veno-arterial extracorporeal membrane oxygenation (VA-ECMO). Fifty-seven patients with cardiogenic OHCA who immediately underwent VA-ECMO upon admission to the emergency department were divided into 27 non-DIC and 30 DIC patients. DIC scores were calculated on admission and 24 h later (day 1).
View Article and Find Full Text PDFFront Cardiovasc Med
December 2024
Department of Critical Care Medicine, Cheeloo College of Medicine, Qilu Hospital (Qingdao), Shandong University, Qingdao, Shandong, China.
Introduction: Cardiac arrest during pregnancy is receiving increasing attention. However, there are few reports on cardiac arrest in nonpregnant women caused by abnormal uterine bleeding (AUB). We report a case in which extracorporeal cardiopulmonary resuscitation (ECPR) was used in a patient with cardiac arrest caused by AUB and coronary vasospasm.
View Article and Find Full Text PDFJ Clin Med Res
December 2024
Department of Surgery, Imamura Hospital, Tosu, Saga, Japan.
Background: Our hospital is a designated emergency hospital and accepts many patients with out-of-hospital cardiac arrest (OHCA). Previously, after receiving a direct call from emergency services to request acceptance of an OHCA patient, the emergency room (ER) chief nurse notified medical staff. However, this method delayed ER preparations, so a Code Blue system (CB) was introduced in which the pending arrival of an OHCA patient was broadcast throughout the hospital.
View Article and Find Full Text PDFJACC Adv
January 2025
Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Centre, Suita, Japan.
Background: Extracorporeal cardiopulmonary resuscitation (ECPR) has allowed patients with refractory out-of-hospital cardiac arrest (OHCA) due to acute myocardial infarction (AMI) to receive primary percutaneous coronary intervention (PCI); they were previously ineligible.
Objectives: The purpose of this study was to clarify the characteristics and outcomes of patients with OHCA secondary to AMI who underwent primary PCI during refractory cardiac arrest despite ECPR.
Methods: Patients with AMI and OHCA aged ≥18 years who underwent PCI with ECPR in 2013 to 2018 were identified from a multicenter ECPR registry in Japan.
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