%20 Lipid Emülsiyon Tedavisi Sonrası Gelişen Şiddetli Hipertrigliseridemi

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Yakar M. N., Hancı V.


  • Publication Type: Conference Paper / Summary Text
  • Page Numbers: pp.59-62
  • Dokuz Eylül University Affiliated: Yes


According to the World Health Organization, every year, 700.000 people die from suicide.1 Suicide accounts for 1.4% of the total number of deaths in Europe.2 In 2019, the rates of suicide deaths in the USA and Turkey were 13.9 and 4.12 per 100,000 people, respectively.3,4 The use of 20%-lipid emulsion therapy (LET) to treat patients with intoxicated is a frequently used modality. In the present case report, we shared our experiences with managing hypertriglyceridemia developed after 20%-LET. A 27-year-old patient with the diagnosis of bipolar affective disorder and Asperger's syndrome was admitted to the emergency department with the complaint of confusion after taking a handful of olanzapine (20 mg), lithium (300 mg), lamotrigine (200 mg), and bupropion (300 mg). He was letargic. The Glasgow coma scale was E3V2M5. The patient with no need for any oxygen support had normal vital parameters (Heart rate:129/min, SpO2:97%, tension arterial:166/92 mmHg, respiratory rate:24/min). No significant pathology was detected in the patient's arterial blood gas analysis and laboratory data (Table 1). Gastric lavage and activated charcoal application were performed. Then he was transferred to the intensive care unit (ICU). After ICU admission, a 2-hour hemodialysis session and 20%-LET with a bolus of 1.5 mL/kg and maintenance of 0.25 mL/kg/min doses were applicated for drug elimination.5 After these therapies, the patient's consciousness was improved. The toxic lithium level returned to normal, but biochemistry tests performed after 20%-LET were reported as lipemic serum. Also, a high Hb level (24.0 g/dL) was observed in hemogram parameters, which could be explained by incorrect measurement. Triglyceride was detected as 4887 mg/dL. The endocrinology department consulted the patient to clarify the need for plasmapheresis, but daily lipid panel testing was recommended. Additionally, we measured the amylase and lipase level daily due to the increased risk of pancreatitis. The patient's high levels of blood lipids dramatically resolved in the consequent days. Additionally, the abnormal hemogram parameters observed after 20%- LET returned to the normal level. The patient was transferred to the psychiatry ward on the fourth day of ICU admission. Written informed consent was obtain from the patient to present this case report. The 20%-LET is frequently used to treat intoxications, but it may cause acute increases in the lipid profile. Therefore, measuring blood lipid levels after 20%-LET and administering lower doses and longer infusion durations in the risky group may reduce the risk of complications.