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대한임상독성학회지 = Journal of the Korean Society of Clinical Toxicology   v.16 no.1, 2018년, pp.9 - 14   KCI후보
본 등재정보는 저널의 등재정보를 참고하여 보여주는 베타서비스로 정확한 논문의 등재여부는 등재기관에 확인하시기 바랍니다.

베라파밀 중독의 쥐 모델에서 지방에멀젼 정맥주사의 효과
The Effect of Intravenous Lipid Emulsion in a Rat Model of Verapamil Toxicity

하대명   (경상대학교 의학전문대학원 응급의학교실  ); 김동훈   (경상대학교 의학전문대학원 응급의학교실  ); 김태윤   (경상대학교 의학전문대학원 응급의학교실  ); 이수훈   (경상대학교 의학전문대학원 응급의학교실  ); 정진희   (경상대학교 의학전문대학원 응급의학교실  ); 이상봉   (경상대학교 의학전문대학원 응급의학교실  ); 임대성   (창원경상대학교병원 응급의학교실  ); 강창우   (경상대학교 의학전문대학원 응급의학교실  );
  • 초록

    Purpose: Intravenous lipid emulsion (ILE) has been shown to have significant therapeutic effects on calcium channel blocker overdose in animal studies and clinical cases. In this preliminary experiment, we investigated the hemodynamic changes and survival in a rat model of verapamil intoxication. Methods: Fourteen male Sprague-Dawley rats were sedated and treated with ILE or normal saline (control), followed by continuous intravenous infusion of verapamil (20 mg/kg/h). Mean arterial pressure and heart rate of rats were monitored during the infusion. In addition, the total dose of infused verapamil and the duration of survival were measured. Results: Survival was prolonged in the ILE group ( $32.43{\pm}5.8min$ ) relative to the control group ( $24.14{\pm}4.3min$ ) (p=0.01). The cumulative mean lethal dose of verapamil was higher in the ILE group ( $4.3{\pm}0.7mg/kg$ ) than in the control group ( $3.2{\pm}0.5mg/kg$ ; p=0.017). Conclusion: ILE pretreatment prolonged survival and increased the lethal dose in a rat model of verapamil poisoning.


  • 주제어

    Intravenous lipid emulsion (ILE)  . Verapamil  . Intoxication  . Poisoning  .

  • 참고문헌 (27)

    1. Mowry JB, Spyker DA, Cantilena LR Jr, Bailey JE, Ford M. 2012 annual report of the American Association Of Poison Control Centers' National Poison Data System (NPDS): 30th annual report. Clin Toxicol (Phila) 2013;51:949-1229. 
    2. Shepherd G. Treatment of poisoning caused by beta-adrenergic and calcium-channel blockers. Am J Health Syst Pharm 2006;63:1828-35. 
    3. Jamaty C, Bailey B, Larocque A, Notebaert E, Sanogo K, Chauny JM. Lipid emulsions in the treatment of acute poisoning: a systematic review of human and animal studies. Clin Toxicol (Phila) 2010;48:1-27. 
    4. St-Onge M, Dube P, Glosselin S, Guimont C, Godwin J, Archambault P, et al. Treatment for calcium channel blocker poisoning: A systemic review. Clin Toxicol. (Phila) 2014;52:926-44. 
    5. Rosenblatt MA, Abel M, Fischer GW, Itzkovich CJ, Eisenkraft JB. Successful use of a 20% lipid emulsion to resuscitate a patient after a presumed bupivacaine-related cardiac arrest. Anesthesiology 2006;105:217-8. 
    6. Foxall G, McCahon R, Lamb J, Hardman JG, Bedforth NM. Levobupivacaine-induced seizures and cardiovascular collapse treated with Intralipid. Anaesthesia 2007;62:516-8. 
    7. Litz RJ, Popp M, Stehr SN, Koch T. Successful resuscitation of a patient with ropivacaine-induced asystole after axillary plexus block using lipid infusion. Anaesthesia 2006;61:800-1. 
    8. Sirianni AJ, Osterhoudt KC, Calello DP, Muller AA, Waterhouse MR, Goodkin MB, et al. Use of lipid emulsion in the resuscitation of a patient with prolonged cardiovascular collapse after overdose of bupropion and lamotrigine. Ann Emerg Med 2008;51:412-5, 415 e1. 
    9. Weinberg G, Di Gregorio G, Hiller D, Hewett A, Sirianni A. Reversal of haloperidol-induced cardiac arrest by using lipid emulsion. Ann Intern Med 2009;150:737-8. 
    10. Yoav G, Odelia G, Shaltiel C. A lipid emulsion reduces mortality from clomipramine overdose in rats. Vet Hum Toxicol 2002;44:30. 
    11. Heinonen JA, Litonius E, Backman JT, Neuvonen PJ, Rosenberg PH. Intravenous lipid emulsion entraps amitriptyline into plasma and can lower its brain concentration-an experimental intoxication study in pigs. Basic Clin Pharmacol Toxicol 2013;113:193-200. 
    12. Bologa C, Lionte C, Coman A, Sorodoc L. Lipid emulsion therapy in cardiodepressive syndrome after diltiazem overdose-case report. Am J Emerg Med 2013; 31:1154.e3-1154.e4. 
    13. Tebbutt S, Harvey M, Nicholson T, Cave G. Intralipid prolongs survival in a rat model of verapamil toxicity. Acad Emerg Med 2006;13:134-9. 
    14. Cave G, Harvey MG, Castle CD. The role of fat emulsion therapy in a rodent model of propranolol toxicity: a preliminary study. J Med Toxicol 2006;2:4-7. 
    15. Bania TC, Chu J, Perez E, Su M, Hahn IH. Hemodynamic effects of intravenous fat emulsion in an animal model of severe verapamil toxicity resuscitated with atropine, calcium, and saline. Acad Emerg Med 2007;14:105-11. 
    16. Kang C, Kim DH, Kim SC, Lee SH, Jeong JH, Kang TS, et al. The effects of intravenous lipid emulsion on prolongation of survival in rat model calcium blocker toxicity. Clin Toxicol (phila) 2015;53:540-4. 
    17. Christian M, Pallasche E, Wahl M, Mycyk M. Lipid Rescue 911: Are poison centers recommanding intravenous fat emulsion therapy for severe poisoning? J Med Toxicol 2013;9:231-4. 
    18. Weinberg GL, Ripper R, Murphy P, Edelman LB, Hoffman W, Strichartz G, et al. Lipid infusion accelerates removal of bupivacaine and recovery from bupivacaine toxicity in the isolated rat heart. Reg Anesth Pain Med 2006;31:296-303. 
    19. Sangster J. Octanol-Water Partition Coefficients: Fundamentals and Physical Chemistry. (secondary). Wiley Series in Solution Chemistry. 2. Chichester: John Wiley & Sons Ltd. 1997:17. 
    20. Available at: http://www.wolframalpha.com. accessed December 27, 2017. 
    21. Van de Velde M, Wouters PF, Rolf N, Van Aken H, Flameng W, Vandermeersch E. Long-chain triglycerides improve recovery from myocardial stunning in conscious dogs. Cardiovasc Res 1996;32:1008-15. 
    22. Stehr SN, Ziegeler JC, Pexa A, Oertel R, Deussen A, Koch T, et al. The effects of lipid infusion on myocardial function and bioenergetics in l-bupivacaine toxicity in the isolated rat heart. Anesth Analg 2007;104:186-92. 
    23. Huang JM, Xian H, Bacaner M. Long-chain fatty acids activate calcium channels in ventricular myocytes. Proc Natl Acad Sci USA 1992;89:6452-6. 
    24. Mottram AR, Valdivia CR, Makielski JC. Fatty acids antagonize bupivacaine-induced I(Na) blockade. Clin Toxicol (Phila) 2011;49:729-33. 
    25. Cave G, Harvey M, Quinn P, Heys D. Hypertonic sodium bicarbonate versus intravenous lipid emulsion in a rabbit model of intravenous flecainide toxicity: no difference, no sink. Clin Toxicol (Phila) 2013;51:395-7. 
    26. Harvey M, Cave G, Ong B. Intravenous lipid emulsion-augmented plasma exchange in a rabbit model of clomipramine toxicity: survival, but no sink. Clin Toxicol (Phila) 2014;52:13-9. 
    27. Perez E, Bania TC, Medlej K, Chu J. Determining the optimal dose of intravenous fat emulsion for the treatment of severe verapamil toxicity in a rodent model. Acad Emerg Med 2008;15:1284-9. 

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