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Methodology for AACT evidence-based recommendations on the use of intravenous lipid emulsion therapy in poisoning

Lookup NU author(s): Professor Simon Thomas

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Abstract

Intravenous lipid emulsion (ILE) therapy is a novel treatment that was discovered in the last decade. Despite unclear understanding of its mechanisms of action, numerous and diverse publications attested to its clinical use. However, current evidence supporting its use is unclear and recommendations are inconsistent. To assist clinicians in decision-making, the American Academy of Clinical Toxicology created a workgroup composed of international experts from various clinical specialties, which includes representatives of major clinical toxicology associations. Rigorous methodology using the Appraisal of Guidelines for Research and Evaluation or AGREE II instrument was developed to provide a framework for the systematic reviews for this project and to formulate evidence-based recommendations on the use of ILE in poisoning. Systematic reviews on the efficacy of ILE in local anesthetic toxicity and non-local anesthetic poisonings as well as adverse effects of ILE are planned. A comprehensive review of lipid analytical interferences and a survey of ILE costs will be developed. The evidence will be appraised using the GRADE system. A thorough and transparent process for consensus statements will be performed to provide recommendations, using a modified Delphi method with two rounds of voting. This process will allow for the production of useful practice recommendations for this therapy.


Publication metadata

Author(s): Gosselin S, Morris M, Miller-Nesbitt A, Hoffman RS, Hayes BD, Turgeon AF, Gilfix BM, Grunbaum AM, Bania TC, Thomas SH, Morais JA, Graudins A, Bailey B, Megarbane B, Calello DP, Levine M, Stellpflug SJ, Hoegberg LC, Chuang R, Stork C, Bhalla A, Rollins CJ, Lavergne V

Publication type: Article

Publication status: Published

Journal: Clinical Toxicology

Year: 2015

Volume: 53

Issue: 6

Pages: 557-564

Print publication date: 01/07/2015

Online publication date: 10/06/2015

Acceptance date: 11/05/2015

Date deposited: 08/06/2016

ISSN (print): 1556-3650

ISSN (electronic): 1556-9519

Publisher: Taylor & Francis

URL: http://dx.doi.org/10.3109/15563650.2015.1052498

DOI: 10.3109/15563650.2015.1052498.

PubMed id: 26059735


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