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The use of intravenous lipid emulsion (ILE) is thought to reverse the acute neurological and cardiac toxicities generated by local anesthetic and non-anesthetic drugs. The aim of this review is to provide an updated overview of ILE therapy in the management of the toxic efects of medications on humans. Indications, mechanisms of action, monitoring, dosing, lipid formulations, adverse efects, and contraindications related to ILE are highlighted. Although ILE therapy was initially utilized for local anesthetic toxicity, its use has been extended to patients with overdoses or poisoning induced by various non-local anesthetic drugs. It has been proposed that intravenous lipid droplets generate a discrete lipophilic phase in the bloodstream into which liposoluble drugs preferentially partition. This partitioning efect, known as the lipid sink phenomenon, is thought to decrease the quantity of drug content in tissues in vital organs. At the same time, other studies have also described several molecular mechanisms that may contribute to ILE efcacy. Potential adverse efects of ILE have also been identified, such as pulmonary toxicity, hypertriglyceridemia, acute pancreatitis, interference with laboratory measurements, fat overload syndrome, worsening of systemic absorption of toxin, and hepatic dysfunction. Intravenous lipid emulsion therapy is gaining wider acceptance in critical care units and emergency rooms as a possible treatment modality for liposoluble drug toxicity. Currently, recommendations on ILE administration in clinical toxicology are mainly based on published case reports and animal studies. Thus, further clinical studies are required to increase knowledge about ILE therapy.

Objective: This study aimed to investigate the mortality relationship between COVID-19 and ABO blood groups and comorbid diseases. The aim of this study was to determine whether ABO blood groups and comorbid diseases can be used as a prognostic factor for hospitalization., Patients and Methods: This retrospective study included patients aged ≥ 18 years presenting to the adult emergency COVID-19 outpatient clinic. COVID-19 patients were divided into four stages according to their clinical status: mild, moderate, severe, and critical. Those with the comorbid disease were classified as Group I, and those without comorbid disease were classified as Group II., Results: Of the 384 patients included in the study, 190 (49.5%) were male and 194 (50.5%) were female, with a mean age of 47.3 ± 18.4 years. The clinical data of the patients were scanned from the hospital automation system. Although the risk of transmission was higher, especially in people with A blood type, this rate was lower in the O blood group. The clinical course of the disease was more severe and the mortality rates were higher in the AB blood group (p < 0.001). In the hospital, 35 people who were treated for COVID-19 disease died., Conclusions: Certain ABO blood types and comorbid diseases were important risk factors for COVID-19 and were associated with mortality. We found that some ABO blood groups and comorbid diseases are associated with COVID-19 and may be important risk factors. While the risk of transmission of COVID-19 is high in blood group A, we think that the clinical course of COVID-19 may be more severe and the death rate higher in blood group AB.

Aims: It is commonly known that stored blood and blood products are heated before transfusion to prevent hypothermia, which leads to increased di-(2-ethylhexyl) phthalate (DEHP) content leaching into the blood and blood products and thereby causes greater conversion of DEHP to mono (2-ethylhexyl) phthalate (MEHP). However, there has been no study in the literature reporting on the amount of toxic phthalates in blood following the erythrocyte suspension (ES) transfused via warming. In this study, we aimed to investigate the DEHP and MEHP content in blood following the heated ES transfusions administered by DEHP-containing and DEHP-free infusion sets., Methods: The study included 30 patients that were randomly divided into two groups with 15 patients each: group I underwent ES transfusion via DEHP-containing infusion sets warmed with blood-fluid warmers, and group II underwent ES transfusion via DEHP-free infusion sets warmed with blood-fluid warmers. DEHP and MEHP levels were measured both before and after transfusion., Results: DEHP-free infusion sets led to no increase in the phthalate content, whereas DEHP-containing infusion sets significantly increased the DEHP and MEHP, where the DEHP level increased almost four times (P = .001)., Conclusion: DEHP-containing products lead to toxicity. Therefore, using DEHP-free medical devices may prevent toxicity in patients undergoing ES transfusion., (© 2021 John Wiley & Sons Ltd.)