Intralipid therapy does not improve level of consciousness in overdoses with sedating drugs: a case series.

Objective: To assess the effect of intralipid emulsion therapy (ILE) in sedating drugs presenting to an urban emergency department.
Methods: Following the introduction of a clinical protocol for the use of ILE a retrospective chart review was undertaken, which describes the use of ILE in treating sedating drug overdose in a facility with a tertiary referral level clinical toxicology unit. Demographic data as well as details of drug ingested, physiological parameters and disposition were extracted from the medical record.
Results: Over a 7 month period nine cases were treated with intralipid, of which two were male and the median age was 33 years (17-52 years). Endotracheal intubation was required in seven cases and of the other two, one required a nasopharyngeal airway for several hours while being observed in a critical care area. One patient was managed in the intensive care unit without intubation. The median duration of ventilation in the seven patients was 31 h (22-82 h), and median length of stay for all nine cases was 63 h (24-133 h).
Conclusion: This study does not support any clinically significant effect of intralipid in sedating drug overdose.
(© 2014 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.)