No support for lipid therapy as an effective antidote in acute intoxication. A systematic literature review and analysis of 114 case reports

: Lipid rescue is increasingly used as treatment of various types of poisoning despite weak scientific evidence. Some experimental studies have confirmed a positive effect, but others have failed. Clinical studies are lacking, wherefore we decided to do a systematic review of all published human cases. Case reports were searched for in PubMed and Web of Science and thereafter examined by two experts according to an assessment form grading the probability for a causal connection between lipid rescue and improved symptoms. A total of 114 case reports were identified. No correlation was found between the ratings of the cases and the fat solubility of the respective toxins. The findings do not support the predication that lipid rescue is an effective antidote, not even in cases involving local anaesthetics. In view of the potentially negative effects of lipid rescue, it seems reasonable to strictly limit its indication to life-threatening situations where conventional therapies have failed.