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    脂肪乳治療-新的證據
    原作者: Fermin Barrueto,肖鋒譯 文章來源: 《中華急診醫學雜志》編輯部 發布日期:2013-06-14

    Title: Lipid Emulsion Therapy - Increasing Evidence
    題目:脂肪乳治療-新的證據
    Author作者: FerminBarrueto

    Utilizing 20% lipid emulsion at a dose of 1.5 mL/kg (100 mL Bolus) IV with repeat in 15 minutes in no response is being recommended in patients hemodynamic instabiity due to poisoning.
    在搶救血流動力學不穩定中毒患者時,可用1.5毫升/公斤(100毫靜推)20%的脂肪乳劑,如沒有反應可在15分鐘內按同樣劑量重復一次。
    Probably more effective in lipophilic drugs is a current theory for the mechanism of action - the "lipid sink". The idea is that the lipids envelope the drug pulling it off its receptors or sequestering it in the intravascular space. A recent paper has added another mechanism - direct inotropic and lusiptropic effects.(1)
    對親脂性藥物更有效可能是其作用機理 - “脂肪沉淀”。這個機制是脂質將藥物包裹使其與藥物受體分離或沉淀在血管內間隙。最近的一篇論文談到了另外一個機制 - 直接的肌力增強效果。
    Also, if you think the therapy is experimental, think again. Another recent paper surveyed Poison Control Centers and found 30/45 Poison Centers in the US have a defined protocol for utilization of lipid emulsion therapy. The PCCs are recommending it more.(2)
    另外,如果你認為這種治療還是處于實驗階段,多思考一下。另一個最近的一篇論文對美國毒物控制中心進行了調查,發現美國30/45毒物中心有一個明確的使用脂肪乳方案。 美國毒物控制中心越來越推薦它的使用。
    What was once considered just a purely experimental therapy only used at the very end of code is becoming more mainstream. Comfort with its safety profile and effiicacy continues to mount.
    一個曾經被認為只是用于搶救末期的實驗性治療,將成為主要的搶救手段。對其安全性和效果的認知會繼續增加。
    References
    Fettiplace MR, Ripper R, Lis K, Lin B, Lang J, Zider B, Wang J,?Rubinstein I, Weinberg G. Rapid Cardiotonic Effects of Lipid Emulsion?Infusion. Crit Care Med. 2013 Mar 25. [Epub ahead of print]??
    Christian MR, Pallasch EM, Wahl M, Mycyk MB. Lipid Rescue 911: Are?Poison Centers Recommending Intravenous Fat Emulsion Therapy for?Severe Poisoning? J Med Toxicol. 2013 May 10. [Epub ahead of print]
     

    文章來源:《中華急診醫學雜志》編輯部

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