靜脈注射脂肪乳劑
Intravenous Fat Emulsion
Intravenous Lipid Emulsion
別名: Intralipid · Liposyn III · IFE · ILE · Intravenous Lipid Emulsion · Lipid Rescue
由 VetSheet 獸醫團隊審訂更新於 2026年4月5日本內容以實證獸醫文獻為本
劑量為合格獸醫專業人員的臨床參考。請務必對照最新仿單及個別病患確認。
各物種劑量
🌎 NA — North America🌍 EU — Europe
狗
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| Parenteral Nutrition (PN) | 25-60% of calories administered. Traditionally not recommended at > 2 g/kg/day for TPN therapy. | IV | CRI | As needed | 🌎 NA |
| Rescue agent for fat-soluble drug/toxin intoxication | IFE 20% via a sterile, peripheral IV catheter as a 1.5 mL/kg bolus over 1-3 minutes, then 0.25-0.5 mL/kg/min for 30-60 min. The bolus could be repeated in case of cardiac arrest. If symptomatic after traditional dosing, consider additional doses of 1.5 mL/kg IV over 30 min q4-6h for 24-36 hours until clinical signs resolve, or maintaining a CRI of 0.5 mL/kg/hour until clinical signs resolve. | IV | Bolus followed by CRI | Until clinical signs resolve | 🌎 NA |
- Parenteral Nutrition (PN): Consult a veterinary nutritionist. Keep PPN solutions below 600 mOsm/L.
- Rescue agent for fat-soluble drug/toxin intoxication: Do not exceed 8 mL/kg/day generally, though this has been exceeded in acute toxicosis without ill effect.
貓
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| Parenteral Nutrition (PN) | 25-60% of calories administered. Traditionally not recommended at > 2 g/kg/day for TPN therapy. | IV | CRI | As needed | 🌎 NA |
| Rescue agent for fat-soluble drug/toxin intoxication | IFE 20% via a sterile, peripheral IV catheter as a 1.5 mL/kg bolus over 1-3 minutes, then 0.25-0.5 mL/kg/min for 30-60 min. The bolus could be repeated in case of cardiac arrest. If symptomatic after traditional dosing, consider additional doses of 1.5 mL/kg IV over 30 min q4-6h for 24-36 hours until clinical signs resolve, or maintaining a CRI of 0.5 mL/kg/hour until clinical signs resolve. | IV | Bolus followed by CRI | Until clinical signs resolve | 🌎 NA |
- Parenteral Nutrition (PN): Consult a veterinary nutritionist.
- Rescue agent for fat-soluble drug/toxin intoxication: Extrapolated from general veterinary/human guidelines.
劑量為合格獸醫專業人員的臨床參考。請務必對照最新仿單及個別病患確認。
概覽
靜脈注射脂肪乳劑 (IFE/ILE) 是一種無菌、無熱原的靜脈注射用脂肪乳劑。
過去主要作為腸胃外熱量與必需脂肪酸來源，現已成為獸醫毒理學中關鍵的急救解毒劑。當傳統療法失效時，它對於治療由高脂溶性藥物引起的危及生命的毒性反應非常有效。
主要臨床應用：
- 毒理學急救： 局部麻醉劑（布比卡因、利多卡因）、大環內酯類（伊維菌素、莫昔克丁）、鈣離子通道阻斷劑（氨氯地平）、β-受體阻斷劑及某些抗憂鬱/抗精神病藥物。
- 腸胃外營養 (PN)： 提供高密度熱量（20% 溶液約 2 kCal/mL）。注意：由於潛在的免疫抑制和感染風險，其在重症患者營養支持中的使用存在爭議。
作用機轉
Toxicologic Mechanism (Antidote):
- "Lipid Sink" Theory: IFE creates an expanded intravascular lipid phase. Highly lipophilic toxins partition out of target tissues (e.g., myocardium, CNS) and into this "lipid sink" within the plasma, reducing the free (active) drug concentration at receptor sites.
- Metabolic/Cardiac Enhancement: Provides a direct energy substrate (free fatty acids) to the myocardium, overcoming mitochondrial lipid metabolism blockade (e.g., by bupivacaine) and increasing intracellular calcium to improve cardiac contractility.
Nutritional Mechanism:
- Provides a dense source of calories and essential fatty acids (linoleic, linolenic acids) necessary for cellular integrity and metabolism.
安全性與警告
禁忌症
- Severe egg yolk allergies
- Abnormal fat metabolism
- Premature and low-birth weight infants (human black box warning)
- Blood coagulation disorders
- Pulmonary disease
- Renal impairment
- Severe liver damage
- Patients at high risk for fat emboli
不良反應
- Sepsis or thrombophlebitis (secondary to IV catheterization)
- Fat overload syndrome (hyperlipidemia, hepatomegaly, icterus, splenomegaly, fat embolism, thrombocytopenia, hemolysis, prolonged clotting times)
- Pulmonary toxicity (temporary)
- GI effects
- Somnolence
- Headache
- Flushing
- Pancreatitis
- Hypercoagulability
- Hypersensitivity
注意事項
Strict aseptic technique and excellent IV catheter care are imperative to prevent sepsis. When used alone, IFE may be given via a peripheral line; when combined with amino acids/dextrose as Total Parenteral Nutrition (TPN), a dedicated central line is required due to hypertonicity. Use with caution in critically ill animals due to potential immunosuppression, exacerbation of pulmonary pathology, and increased infection rates. Blood samples for diagnostics should be drawn prior to administration to avoid severe lipemia artifacts (falsely high hemoglobin, MCH, MCHC, and altered bilirubin).
藥物交互作用
IFE may act as a 'lipid sink', reducing the free circulating levels and clinical efficacy of concurrently administered lipophilic medications.
監測
- Serum/plasma drug levels (for toxicology tracking)
- Blood glucose
- Serum triglycerides and gross lipemia
- PCV and Total Protein
- IV catheter site status (phlebitis/sepsis)
- Hydration status and vital signs (temp, HR, RR)
- Serum electrolytes (including phosphorus)
- Renal and liver function tests
- CBC
- Coagulation times (if using heparin)
藥物動力學
吸收
Administered intravenously; 100% bioavailable.
分佈
Removed from the blood stream about as rapidly as chylomicrons.
代謝
Requires prior lipolysis of IFE into free fatty acids. Clearance seems to be increased with heparin-activated lipoprotein lipase.
排除
Elimination half-life in humans is about 30 minutes.
過量
In the event of inadvertent overdose or severe fat overload, stop the infusion until the lipid has cleared from the plasma. Clearance can be evaluated visually (inspecting hematocrit tubes for lipemia) or via laboratory methods (triglyceride concentrations, nephelometry).
If severe hyperlipidemia occurs during toxicity treatment, heparin therapy (75-250 Units/kg SQ q6h) may be considered to increase lipid clearance via lipoprotein lipase activation. However, weigh risks carefully, as heparin may alter the antidote mechanism. Monitor PTT; if PTT exceeds 2-2.5X normal, lower heparin dose (75 Units/kg SQ q6-8h) or discontinue.
可用產品
劑型
- Intravenous injection (10%, 20%, 30% emulsions)
人用標示
- Fat Emulsion, Intravenous 10%, 20%, 30% in 50 mL, 100 mL, 200 mL, 250 mL, & 500 mL bottles or bags (Intralipid, Liposyn II, Liposyn III)
各地核准狀態
暫無法規資料: 🇺🇸 US · 🇪🇺 EU · 🇬🇧 UK · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
儲存與穩定性
Store unopened products at room temperature (not above 25°C / 77°F). Do not freeze; discard if accidentally frozen. Once opened, store the remaining product in the refrigerator (2-8°C) and discard after 24 hours. A new bag/vial must be used every 24 hours. Admixtures must be used promptly or stored under refrigeration for 24 hours or less.
飼主須知
靜脈注射脂肪乳劑 (IFE) 是一種僅限醫院使用的專業治療。
- 用於中毒： 它在血液中起著「海綿」的作用，吸收某些嚴重的、危及生命的毒素（如心臟藥物、局部麻醉劑或某些驅蟲藥）。當標準治療無效時，它可以作為挽救生命的急救療法。
- 用於營養： 它為無法進食且需要靜脈餵食的寵物提供必需的熱量和脂肪。
- 由於它是直接靜脈注射，您的寵物需要住院、放置靜脈導管，並由獸醫團隊密切監測，以防出現感染或血液中脂肪過載的跡象。
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