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J Med Toxicol. Jun 2008; 4(2): 71–76.
PMCID: PMC3550140
Intralipid infusion ameliorates propranolol-induced hypotension in rabbits
Martyn G. Harveycorresponding author and Grant R. Cave
Department of Emergency Medicine, Waikato Hospital, Pembroke St., 2001 Hamilton, New Zealand
Emergency Medical Systems, Australia, Melbourne, Australia
Martyn G. Harvey, harveym/at/waikatodhb.govt.nz.
corresponding authorCorresponding author.
Abstract
Objective
Recent case reports of successful amelioration of lipid-soluble drug toxidromes with Intralipid infusion have prompted interest in the scope of lipid emulsions as antidotal therapy. Propranolol is a highly lipid-soluble, nonselective beta-blocker with additional local-anaesthetic properties. We explored the hypothesis that propranolol toxicity may be similarly attenuated by Intralipid infusion in a rabbit model.
Methods
Twenty sedated, invasively monitored, and mechanically ventilated New Zealand White rabbits underwent propranolol infusion at 4.2 mg/min to a target mean arterial pressure (MAP) of 60% baseline MAP. Animals subsequently received 6 ml/kg 20% Intralipid, or 6 ml/kg 0.9% saline solution over a 4-minute period. Pulse rate and MAP were recorded at 2.5-minute intervals to 15 minutes.
Results
MAP was greatest in the Intralipid group (median 69 mmHg, interquartile range [IQR] 17.5 mmHg Intralipid vs. median 53 mmHg, IQR 12.75 mmHg saline;p = 0.029) at 15 minutes. No difference was observed in first derivative of MAP, or pulse rate between groups.
Conclusions
Propranolol-induced hypotension is ameliorated by Intralipid infusion in this intact rabbit model. The mechanism of action remains to be elucidated.
Full Text
The Full Text of this article is available as a PDF (156K).
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
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