title: Intralipid™ administration attenuates the hypotensive effects of acute intravenous amiodarone overdose in a swine model.
abstract: OBJECTIVE
  To investigate whether a lipid emulsion could counteract the hypotensive effects of amiodarone overdose after an acute intravenous administration and improve 4 h survival in an established model of swine cardiovascular research.
  
  
  METHODS
  Twenty pigs were intubated and instrumented to measure aortic pressures and central venous pressures (CVP). After allowing the animals to stabilize for 60 minutes, amiodarone overdose (1 mg/kg/min) was initiated for a maximum of 20 minutes. Afterwards, the animals were randomized into 2 groups. Group A (n = 10) received 0.9% Normal Saline (NS) and Group B (n = 10) received 20% Intralipid® (ILE). A bolus dose of 2 ml/kg in over 2 min time was initially administered in both groups followed by a 45 min infusion (0.2 ml/kg/min) of either NS or ILE.
  
  
  RESULTS
  All animals survived the overdose and all animals survived the monitoring period of 4 hours. Systolic aortic pressure (SpthAorta) (6.90 vs 14.10 mmHg, P = .006) and mean arterial pressure (MAP) (6.10 vs 14.90 mmHg, P = .001) were higher in the ILE group 2 min after the bolus ILE infusion. This difference was maintained for 15 min after ILE infusion for both SpthAorta (7.85 vs 13.15 mmHg, P = .044) and MAP (7.85 vs 13.15 mmHg, P = .042). Animals that received ILE had higher CVP (11.6 vs 15.7 mmHg, P = .046), an effect which was attenuated 2 and 4 hours post administration. Animals receiving ILE were more acidotic (7.21 vs 7.38, P = .048) in the monitoring period compared to animals receiving NS.
  
  
  CONCLUSIONS
  Intralipid attenuated the hypotensive effects of amiodarone toxicity for a period of 15 minutes compared to animals receiving NS.
authors.affiliation: European University Cyprus, School of Medicine, Nicosia, Cyprus; Hellenic Society of Cardiopulmonary Resuscitation, Athens, Greece.
authors.forename: Theodoros
authors.initials: T
authors.lastname: Xanthos
authors.affiliation: Experimental - Research Center ELPEN, Athens, Greece.
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Psichalakis
authors.affiliation: Cardiff Metropolitan University, Cardiff, UK.
authors.forename: David
authors.initials: D
authors.lastname: Russell
authors.affiliation: Experimental - Research Center ELPEN, Athens, Greece.
authors.forename: Apostolos
authors.initials: A
authors.lastname: Papalois
authors.affiliation: General Hospital of Nikaia, 3rd Department of Internal Medicine, Athens, Greece.
authors.forename: Anastasios
authors.initials: A
authors.lastname: Koutsovasilis
authors.affiliation: Avesta Hospital, Avesta Health Center, Avesta, Sweden.
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Athanasopoulos
authors.affiliation: National and Kapodistrian University of Athens, Medical School, Aretaieion University Hospital, 2nd Department of Surgery.
authors.forename: Georgios
authors.initials: G
authors.lastname: Gkiokas
authors.affiliation: Hellenic Society of Cardiopulmonary Resuscitation, Athens, Greece; National and Kapodistrian University of Athens, Medical School, Postgraduate Study Program (MSc) "Cardiopulmonary Resuscitation", Athens, Greece. Electronic address: thanoschalkias@yahoo.gr.
authors.forename: Athanasios
authors.initials: A
authors.lastname: Chalkias
authors.affiliation: Hellenic Society of Cardiopulmonary Resuscitation, Athens, Greece; National and Kapodistrian University of Athens, Medical School, Postgraduate Study Program (MSc) "Cardiopulmonary Resuscitation", Athens, Greece.
authors.forename: Nicoletta
authors.initials: N
authors.lastname: Iacovidou
mesh_terms: D000208:Acute Disease; D000638:Amiodarone / Q000633:toxicity*; D000818:Animals; D001794:Blood Pressure / Q000187:drug effects*; D004195:Disease Models, Animal; D004305:Dose-Response Relationship, Drug; D062787:Drug Overdose / Q000188:drug therapy*; D004655:Emulsions / Q000008:administration & dosage; D005217:Fat Emulsions, Intravenous / Q000008:administration & dosage; D005260:Female; D010743:Phospholipids / Q000008:administration & dosage*; D026941:Sodium Channel Blockers / Q000633:toxicity; D013024:Soybean Oil / Q000008:administration & dosage*; D013552:Swine
chemical_list: D004655:Emulsions; D005217:Fat Emulsions, Intravenous; D010743:Phospholipids; D026941:Sodium Channel Blockers; C545823:soybean oil, phospholipid emulsion; D013024:Soybean Oil; D000638:Amiodarone