Lipid Resuscitation therapy for LAST (local anesthetic systemic toxicity)

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Tue, 12/03/2024 - 16:39
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Saduf Ashfaq
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Lipid Resuscitation therapy for LAST (local anesthetic systemic toxicity)

Hello everyone,

I would love to know what other facilities have in place for administering lipid resuscitation therapy for LAST.

At my facility, we have a panel built for a bolus of 1.5 mL/kg/dose followed by an infusion of 0.25-0.5 mL/kg/min.

However, if you calculate the dose for a 65kg patient, the rates are as follows for a 20% lipid solution:
- Bolus ends up being 5850 mL/hr
- infusion ends up being 0-1950 mL/hr

I found some information from American College of Medical Toxicology for the bolus dose. It states to draw up the volume into 50mL syringes and administer as IV push.

And then recommends the lipids be administered on a pump. However, our pump can't go above 999 mL/hr.

How are other facilities administering the very high rate of lipid infusion? Are you administering it wide open? Are you getting multiple pumps?

Thank you!

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