Hemodynamic effects of intravenous, high-dose lipid emulsion with and without metoprolol infusion in healthy volunteers: a randomized clinical trial

In a double-blinded, randomized, cross-over trial, we investigated hemodynamic effects of high-dose intravenous lipid emulsion (ILE) with/without metoprolol. Ten healthy volunteers each completed four trial days (placebo+ILE; metoprolol+placebo; metoprolol+ILE; placebo+placebo) in random order. Metoprolol was administered as an initial bolus (10 mg), followed by an infusion (50 mg) from 5 to 30 min. ILE was administered as a bolus at 12.5 min (2.5 ml/kg), followed by a 15-min infusion (0.25 ml/kg/min). On metoprolol+ILE days (compared to metoprolol+placebo) after 120-minutes, mean heart rates were significantly higher (difference: 5.5 beats per minute (bpm) (95% CI: 3.0-8.1) (p<0.001)); and average relative cardiac output was higher (difference: 10 percent point 95% CI: 5-15, p<0.001). Hemodynamic effect of ILE developed gradually. ILE had no effect on plasma metoprolol or major adverse events. In conclusion, high-dose ILE has relatively marginal and delayed hemodynamic effects that may have limited clinical relevance in the acute clinical toxicological setting. This article is protected by copyright. All rights reserved.