It is frequently reported that there is no credible evidence to support their use. There is controversy regarding the benefits and efficacy of intravenous intralipid therapy in patients with a poor reproductive history. The presence of abnormal uterine natural killer (uNK) cells needs more study as a target marker to determine those who could benefit. Although intravenous intralipid is not recommended as a routine treatment for recurrent miscarriage or implantation failure, there is enough data to suggest consideration in selected patients where routine testing is unremarkable, standard treatments have failed and immunological risk factors are present. Twelve studies encompassing 2676 participants met the criteria for selection and were included and reviewed. The most relevant outcome measures were considered to be clinical pregnancy rate (CPR), live birth rate (LBR), implantation rate (IR) and miscarriage rate (MR). These cohorts were compared with either placebo, no intervention or alternative treatments. PubMed, Embase and Scopus searches were performed with the target populations being either recurrent pregnancy loss (RPL), or recurrent implantation failure (RIF) undergoing assisted reproductive technology (ART) and receiving intralipid infusions. While individual studies may be perceived as weak, a systematic review and meta-analysis were performed to determine if there is any advantage to patients. It is frequently reported that there is no evidence to support the effectiveness, utility or safety for this treatment. PMID: 32974650.Controversy exists regarding the benefits of intravenous intralipid therapy in patients with a poor reproductive history. Compatibility of medications with intravenous lipid emulsions: Effects of simulated Y-site mixing. Ross EL, Salinas A, Petty K, Her C, Carpenter JF. Data regarding Y-site compatibility for one lipid emulsion product cannot be safely extrapolated to another without additional testing.
The two combinations that met USP criteria for physical incompatibility were cisatracurium 2 mg/mL with Intralipid and gentamicin 2 mg/mL with Smoflipid.Ĭonclusion: Three different lipid emulsions were physically compatible at the Y site with the majority of medications tested. Incompatibilities differed for the different brands of lipid emulsion.
Results: Most combinations tested were physically compatible based on USP regulations. Physical compatibility was determined by measuring the percentage of fat residing in globules larger than 5 µm (PFAT5) per USP recommendations. Each sample was then diluted with particle-free water and analyzed using the analytical technique of light obscuration recommended in United States Pharmacopeia (USP) general information chapter 729 (USP ). Methods: Medications at commonly used pediatric concentrations were mixed in a 1:1 ratio with lipid emulsions (Intralipid, Nutrilipid, and Smoflipid) and incubated at room temperature for 4 hours to simulate Y-site administration. Purpose: To determine the physical intravenous Y-site compatibility of 19 commonly used medications at pediatric concentrations with 3 different types of lipid emulsion.
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