scholarly journals Successful usage of intravenous lipid emulsion in treatment of acute verapamil poisoning: A case report

2017 ◽  
Vol 74 (3) ◽  
pp. 278-281 ◽  
Author(s):  
Gordana Vukovic-Ercegovic ◽  
Natasa Perkovic-Vukcevic ◽  
Snezana Djordjevic ◽  
Zoran Segrt ◽  
Olivera Potrebic ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Case Report ◽  
Heart Block ◽  
Lipid Emulsion ◽  
Complete Heart Block ◽  
Lipid Emulsions ◽  
Therapy Failure ◽  
Intravenous Lipid Emulsion ◽  
Arterial Blood ◽  
Verapamil Poisoning

Introduction. During the last few years, intravenous lipid emulsions have been effectively used in treatment of acute poisonings with lipophilic substances, including verapamil. Case report. A 37-year-old women presented 1 hour after ingestion of 2.8 g verapamil with hypotension and complete heart block. Because of the applied standard therapy failure and further patients impairment, Intralipid? 20% was used. Sinus rhythm was restored, arterial blood pressure increased and verapamile concentrations, both total and free decreased. Conclusion. Intravenous lipid emulsion can be important in treatment of severe acute intoxication and cardiotoxicity caused by verapamil.

scholarly journals The Effects of Intravenous Lipid Emulsion Therapy in the Prevention of Depressive Effects of Propofol on Cardiovascular and Respiratory Systems: An Experimental Animal Study

2018 ◽  
Author(s):  
Fatih Doğanay ◽  
Rohat Ak ◽  
Halil Alışkan ◽  
Serdar Abut ◽  
Engin Sümer ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Side Effects ◽  
Respiratory Depression ◽  
Lipid Emulsion ◽  
Toxic Effects ◽  
Anesthesia Induction ◽  
Mixed Effect ◽  
Intravenous Lipid Emulsion ◽  
Arterial Blood ◽  
Respiratory Systems

Abstract: Background and objective: Propofol is an anesthetic agent that is frequently used in anesthesia induction, maintenance and sedation. Propofol has severe side effects such as hypotension, bradycardia and respiratory depression. Although propofol is commonly used, there is no known antidote for its toxic effects. An approach to prevent toxic effects of propofol would be beneficial. The aim of this study was to assess the effects of intravenous lipid emulsion (ILE) therapy in the prevention of depressive effects of propofol on cardiovascular and respiratory systems. Materials and methods: Twenty-eight Sprague-Dawley adult rats were randomly divided into 4 groups. The saline-administered group was determined as the Control group. The second group was administered propofol (PP group); the third group was administered ILE (ILE group), and the fourth was administered propofol with ILE therapy (ILE+PP group). Systolic blood pressure (SBP), Diastolic blood pressure (DBP), Mean arterial blood pressure (MAP), Respiratory rate (RR), Heart rate (HR) and mortality were recorded at 10 points during 60 minutes. A repeated measures linear mixed-effect model with unstructured covariance was used to compare the groups. Results: In the PP group, SBP, DBP, MAP, RR and HR levels were declining steadily; all rats in this group died after 60 minutes. In the ILE+PP group, after a while, the decreased SBP, DBP, MAP, RR and HR levels increased SBP, DBP, MAP, RR and HR levels of the Propofol group were found to be significantly lower than those of the other groups (p<0.01). The mortality rate was 100% (surviving period, 60 min) for the PP group, whereas 0% for the ILE, ILE+PP and Control groups. Conclusion: Our results suggest that undesirable side effects that can be seen after propofol application such as hypotension, bradycardia and respiratory depression might be prevented by using ILE therapy.

scholarly journals The Effects of Intravenous Lipid Emulsion Treatment in the Preventi̇on of Depressive Effects of Propofol on Cardiovascular and Respiratory System: An Experimental Animal Study

2018 ◽  
Author(s):  
Fatih Doğanay ◽  
Rohat Ak ◽  
Halil Alışkan ◽  
Serdar Abut ◽  
Engin Sümer ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Side Effects ◽  
Respiratory System ◽  
Lipid Emulsion ◽  
Control Group ◽  
Anesthesia Induction ◽  
Survival Ratio ◽  
Adult Rats ◽  
Intravenous Lipid Emulsion ◽  
Arterial Blood

Propofol is the general anesthetic used for the anesthesia induction and its continuation. Propofol is generally safe and it doesn't have an antidote. Propofol has severe side effects such as cardiovascular depression and hypotension. The aim of this study was observed the effects of intravenous lipid emulsion (ILE) treatment in the preventi̇on of depressive effects of propofol on cardiovascular and respiratory system. Twenty-eight Sprague-Dawley adult rats randomly divided into 4 groups. The saline administered group was defined as the control group. The second group administered propofol, the third group administered ILE, and the fourth administered propofol with ILE therapy. Systolic blood pressure (SBP), Diastolic blood pressure (DBP), Median arterial blood pressure (MAP), Respiratory rate (RR), Heart rate (HR) and mortality were recorded during 60 minutes of follow-up. In the propofol group, SBP, DBP, MAP, RR and HR scores were decline steadily, after 60 minutes all rats in this group died. In the ILE group with propofol, after a while, decreased SBP, DBP, MAP, RR and HR scores was increased, and these values were observed close to the control group. The mortality ratio of the propofol group was detected as 100%, and survival ratio was found 100% in ILE + propofol group. The side effects such as hypotension, bradycardia and respiratory depression which can be seen after propofol application in rats could be recovered with ILE treatment and mortality due to these side effects were prevented.

scholarly journals Intravenous lipid emulsion in treatment of cardiocirculatory disturbances caused by glyphosate-surfactant herbicide poisoning

2016 ◽  
Vol 73 (4) ◽  
pp. 390-392 ◽  
Author(s):  
Jasmina Jovic-Stosic ◽  
Vesna Putic ◽  
Natasa Perkovic-Vukcevic ◽  
Gordana Babic ◽  
Snezana Djordjevic ◽  
...  
Keyword(s):  
Case Report ◽  
Lipid Emulsion ◽  
Genetically Modified Crops ◽  
Acute Poisoning ◽  
Commercial Products ◽  
Arterial Blood Gas ◽  
Intravenous Lipid Emulsion ◽  
Arterial Blood ◽  
Low Toxicity ◽  
Glyphosate Herbicide

Introduction. Glyphosate is the first widely used herbicide against weed in genetically modified crops. Though glyphosate itself has a low toxicity, commercial products are more dangerous because of increased toxicity due to surfactants addition. There is no specific antidote for the poisoning with glyphosate-surfactant (Gly-SH). In recent times, the efficacy of intravenous lipid emulsion (ILE) administration for the treatment of acute poisoning caused by Gly- SH has been investigated. Case Report. A 50-year-old man was admitted 3 hours after self-poisoning with herbicide containing glyphosate and polyoxyethyleneamine, as a surfactant. On admission, the patient was in a coma, hypotensive (80/50 mmHg) and without spontaneous breathing. Electrocardiogram showed widecomplex tachycardia, and arterial blood gas (ABG) revealed acidosis (pH 7.07). Conventional treatment included mechanical ventilation, intravenous fluids, bicarbonate and dopamine. As there was no improvement, ILE was started. The patient received 100 mL of 20% Intralipid? bolus followed by infusion of 400 mL over 20 minutes. Prior to expiration of infusion, a gradual rise in blood pressure was noted, and within 2 hours sinus rhythm was restored. Conclusion. This case report suggests that the use of ILE may be an additional option for the treatment of cardiocirculatory disturbances caused by commercial products of glyphosate herbicide.

alpha- and beta-Adrenergic effects of epinephrine on ventricular pacemakers in dogs

1982 ◽  
Vol 242 (4) ◽  
pp. H677-H682
Author(s):  
A. J. Hordof ◽  
E. Rose ◽  
P. Danilo ◽  
M. R. Rosen
Keyword(s):  
Blood Pressure ◽  
Heart Block ◽  
Complete Heart Block ◽  
Ventricular Rate ◽  
Epinephrine Infusion ◽  
Arterial Blood ◽  
Idioventricular Rhythm ◽  
Alpha Blockade ◽  
Ventricular Automaticity ◽  
Adrenergic Effects

We studied the effects of epinephrine on idioventricular rhythm in 15 adult dogs with chronic complete heart block induced by the injection of formalin into the His bundle. Atropine (0.1 mg/kg) was given intravenously to attenuate any potential vagal effects, and epinephrine was infused in graded doses of 0.01-10.0 micrograms.kg-1.min-1. Two different responses were seen. In 12 dogs there was a concentration-dependent increase in ventricular rate following epinephrine infusion. These animals then were given the beta-blocker propranolol (0.5 mg/kg iv), and the epinephrine infusions were repeated. In this situation epinephrine concentrations less than 0.1 micrograms.kg-1.min-1 induced a decrease in ventricular rate with no associated change in arterial pressure. In four additional dogs this decrease in ventricular rate was prevented by alpha-blockade with phentolamine. In three dogs epinephrine less than 0.1 micrograms.kg-1.min-1 induced a decrease in ventricular rate without an associated change in arterial blood pressure. This decrease in rate was abolished by the alpha-blocker phentolamine. It therefore appears that an alpha-adrenergic effect on ventricular automaticity can occur in the intact animals. When this does not occur initially, it can be unmasked by propranolol and results in a slowing of ventricular rate unrelated to changes in blood pressure.

scholarly journals Refractory Hypertensive Emergency associated with Complete Heart Block Resolved after Permanent Pacemaker Implantation: A Case Report

2021 ◽  
Author(s):  
Moinuddin Choudhury ◽  
Narendra Kumar ◽  
Shajil Chalil ◽  
Khalid Abozguia
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Case Report ◽  
Heart Block ◽  
Severe Hypertension ◽  
Complete Heart Block ◽  
Pacemaker Implantation ◽  
Permanent Pacemaker ◽  
Hypertensive Emergency ◽  
Permanent Pacemaker Implantation

Severe hypertension sometimes improves with treatment of bradycardia but this phenomenon is under-reported. Here an elderly gentleman with complete heart block and a hypertensive emergency was refractory to medical therapies and blood pressure only improved following pacemaker implantation. We discuss the possible mechanisms relating to heart rate and artificial pacing.

About contraindications to the use of digitalis

1930 ◽  
Vol 26 (10) ◽  
pp. 1052-1052
Author(s):  
D. Scherf
Keyword(s):  
Blood Pressure ◽  
High Blood Pressure ◽  
Heart Block ◽  
Blood Circulation ◽  
Complete Heart Block ◽  
Minute Volume ◽  
Absolute Contraindication ◽  
Conduction Disturbances ◽  
Digitalis Therapy ◽  
General Pathology

Abstracts. General pathology and therapy. About contraindications to the use of digitalis D. Scherf (Dioarztliche Praxis No. 1-1930) considers it unreasonable to be afraid of digitalis with sometimes concomitant cardiac weakness of bradycardia, since digitalis contributes to lengthening diastole, better filling the ventricles, increasing their contractions and increasing minute volume, and a trace, and improve blood circulation. In case of conduction disturbances, one should not always be afraid of using digitalis'a, since practice has shown that a complete heart block coming from digitalis'a sometimes improves the patient's condition. High blood pressure is not an absolute contraindication for digitalis therapy, as for reasons unknown to us, digitalis often lowers blood pressure.

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