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Corresponding author. Corresponding author: Il-Woo Shin, M. Tel: , Fax: , rk. This article has been cited by other articles in PMC. Abstract Background Lipid emulsions have been used to treat various drug toxicities and for total parenteral nutrition therapy.
Their usefulness has also been confirmed in patients with local anesthetic-induced cardiac toxicity. The purpose of this study was to measure the hemodynamic and composition effects of lipid emulsions and to elucidate the mechanism associated with changes in intracellular calcium levels in myocardiocytes.
We measured the effects of the lipid emulsions on intracellular calcium levels in H9c2 cells by confocal microscopy. Both lipid emulsion treatments increased intracellular calcium levels. Conclusions These two lipid emulsions had different inotropic effects depending on their triglyceride component. The inotropic effect of lipid emulsions could be related with intracellular calcium level. Keywords: Calcium, Heart, Myocardial contraction, Intralipid, Lipofundin Introduction Lipid emulsions LE have been used as total parenteral nutrition TPN [ 1 , 2 ] and as therapeutic drugs for various drug toxicities, such as psychotropic drugs haloperidol and tricyclic antidepressants , calcium channel blockers, beta-blockers, parasiticides, or herbs non-local anesthetic drug toxicity [ 3 , 4 ].
Systemic local anesthetic toxicity is a rare but potentially fatal complication that is intractable to conventional cardiopulmonary resuscitation [ 5 ]. Systemic local anesthetic toxicity also has a risk of progressing to "recurrent systemic local anesthetic toxicity after successful resuscitation" [ 6 ].
Intravenous infusion of LEs reverses intractable cardiac toxicity in an animal model [ 7 , 8 ], and LEs are effective for treating local anesthetic-induced cardiac toxicity [ 3 , 5 , 9 , 10 , 11 ]. Therefore, various studies associated with LEs have been actively conducted to understand the mechanism of lipid rescue and improve treatment regimens. However, both types of LE affect hemodynamics in an ex vivo model but the associated cellular mechanism remains unknown.
Animal preparation and surgery were performed as described previously [ 12 ]. If the tail moved i. A tracheostomy was performed, and the animals were mechanically ventilated with room air via a 16 G catheter. The chest cavity was opened, and the heart was excised rapidly. The heart was mounted quickly on a Langendorff perfusion system and perfused with modified Krebs-Henseleit solution mM NaCl, 4.
Perfusion pressure was maintained at 70 mmHg with a 95 cm high fluid column and an overflow pump. Each experimental group was injected with the drug using an infusion pump Auto Syringe AS50 Infusion Pump; Baxter, Singapore through a three-way stopcock on the fluid column. The sample size calculation was based on a preliminary study.
Randomization was allocated by one author with a numbered container. Hemodynamic functions at baseline and the maximum response after the LE infusion were measured. Cover slips were inserted into a chamber mounted on the stage of the confocal microscope and rinsed with a warm normal bath solution mM NaCl, 5.
Fluorescent images were collected every 0. The LE concentration used was 0. All analyses were performed using SPSS statistical software ver. Experimental outcomes were analyzed using one-way analysis of variance and the Bonferroni post-hoc test. Results Effect of LE on hemodynamic functions of hanging hearts in a Langendorff perfusion system Hemodynamic functions were checked at baseline and during the maximum response after LE infusion.
Lipofundin MCT/LCT 10% – 20%
LIPOFUNDIN MCT/LCT 20% EMULSION FOR INFUSION