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The American Academy of Clinical Toxicology's Lipid Emulsion workgroup has published its first of 4 systematic reviews on the use of lipid emulsion in toxicology, this one on lipid's effect on laboratory analyses. [1] As expected, administering a fat bolus can significantly alter labs drawn subsequently.
The key point: If you are considering lipid for overdose, draw labs prior to giving it.
Which labs are affected? Most. Here's a helpful mnemonic courtesy of Dr. Kyle DeWitt.
- B - Blood Gas
- L - Liver transaminases
- E - Electrolytes
- A - Analgesics (acetaminophen, salicylates)
- C - Coags
- H - H/H, platelets
Also remember to give lipid in its own line. It isn't compatable with most resuscitation drugs. [2]
References
- Grunbaum AM, et al. Review of the effect of intravenous lipid emulsion on laboratory analyses. Clin Toxicol 2015 Dec 1:1-11. [Epub ahead of print, PMID 26623668]
- Cocchio C, et al. Physiochemical Stability of Intravenous Fat Emulsion in Combination with Medications Used for Resuscitation. SOJ Pharm PharmSci 2014;1(1):3. (open access)
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