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Lipid Therapy for Cardiac Arrest

Question Type:
Intervention
Full Question:
In adult patients with cardiac arrest due to suspected drug toxicity (eg, local anesthetics, tricyclic antidepressants, others)  (P), does does administration of IV lipid  (I), compared with compared with no IV lipid  (C), change Survival with Favorable neurological/functional outcome at discharge, 30 days, 60 days, 180 days AND/OR 1 year, Survival only at discharge, 30 days, 60 days, 180 days AND/OR 1 year, ROSC (O)?
Consensus on Science:
We identified no human comparative studies in cardiac arrest and periarrest states relevant to the PICO question. Many case reports and case series described resuscitation that included administration of lipid.
Treatment Recommendation:
We are unable to make any evidence-based treatment recommendation about the use of IV lipid emulsion to treat toxin-induced cardiac arrest. Values, Preferences, and Task Force Insights Although there are many case reports and case series of patients who were resuscitated after administration of IV lipid, the absence of any comparative data made it impossible to determine anything besides temporal association of the therapy with outcome. Despite the paucity of data, we do not wish to discourage the use of an antidote with some theoretical basis in a dire clinical situation.
CoSTR Attachments:
ALS-834 Lipid Therapy for Cardiac Arrest 2015-02-03 posted for public comment.pdf    

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