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Toxicol."],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Practitioners routinely use intravenous lipid emulsion for local anesthetic systemic toxicity, but its role in non-local anesthetic poisonings remains unclear. We conducted a systematic review and meta-analysis comparing lipid emulsion with standard care for non-local anesthetic toxicities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We searched PubMed, Embase, Scopus and Web of Science from January 1st 2010 until March 16th 2026 for human randomized controlled trials evaluating lipid emulsion for non-local anesthetic poisoning. Volunteer studies and pediatric-only studies were excluded. The primary outcome was intensive care unit admission (with intubation as a surrogate for unit-level needs). Secondary outcomes included mortality, seizures, and hospital length of admission. Risk of bias was assessed using the Cochrane Risk of Bias 2 tool. Random-effect meta-analysis was conducted. Heterogeneity was analyzed using Cochran\u2019s Q and I\n                      <jats:sup>2<\/jats:sup>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Twelve studies with 816 patients were included, predominantly using 20% SMOFlipid\u00ae 280 \u2013 500 mL. Lipid emulsion reduced intensive care unit admission compared to standard care (RR=0.70; 95% CI: [0.53, 0.93], 8 studies, n=369) with moderate heterogeneity (Q=9.43, p=0.02; I\n                      <jats:sup>2<\/jats:sup>\n                      =32.12%). Lipid emulsion also reduced mortality (RR=0.65; 95% CI: [0.53, 0.80]) and length of admission (Mean diff. =-34.16; 95% CI: [-42.29,-26.02]). Seizure incidence was lowered but not significantly (RR=0.27; 95% CI [0.06, 1.26]).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Intravenous lipid emulsion is associated with reduced intensive care unit admission and mortality for aluminum phosphide and organophosphate poisonings and a reduced length of admission for aluminum phosphide, organophosphate, and antipsychotic poisonings. The evidence is limited by study heterogeneity and study quality. Larger, high-quality trials are needed to confirm benefit.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Registration Number<\/jats:title>\n                    <jats:p>CRD42025645519<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s13181-026-01151-7","type":"journal-article","created":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T14:21:25Z","timestamp":1787840485000},"page":"461-471","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Systematic Review and Meta-Analysis of Lipid Emulsion for Non-Local Anesthetic Poisoning"],"prefix":"10.1007","volume":"22","author":[{"given":"Zhengxin","family":"Tang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Megan","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandra","family":"Barabanova","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Quincy","family":"McCrary","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6946-8355","authenticated-orcid":false,"given":"Michael R.","family":"Fettiplace","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,8,27]]},"reference":[{"key":"1151_CR1","doi-asserted-by":"publisher","first-page":"783","DOI":"10.1097\/PRS.0000000000005989","volume":"144","author":"M Gitman","year":"2019","unstructured":"Gitman M, Fettiplace MR, Weinberg GL, Neal JM, Barrington MJ. 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