Sea turtles included in this study stranded on Florida’s west coast from 27 Mar– ( N = 14) and from 9 Oct– ( N = 4). within 6–24 h) and at removing brevetoxins from the bloodstream with no adverse effects due to the treatment 12 however, the effectiveness of ILE in sea turtles naturally exposed to brevetoxins remains unknown. A recent brevetoxin-exposure study using red eared sliders ( Trachemys scripta elegans) as a model for sea turtles showed ILE to be highly effective at rapidly eliminating symptoms (i.e. Brevetoxins bound to the lipids from ILE would then likely be eliminated through the liver, bile, and feces 27, 28. Other hypothesized mechanisms of action include energetic and metabolic effects 25, 26. brevetoxins 10), likely as a result of the expanded, intravascular “lipid sink”, which either draws toxins out of tissues allowing them to bind to lipids in the bloodstream or prevents toxins from reaching target tissues 21, 23, 24. It is effective against lipid soluble agents (e.g. In the last decade, physicians and veterinarians have begun to use intravenous lipid emulsion (ILE) in the treatment of various acute intoxications 20, 21, 22. Previous studies have shown that total clearance time of the toxins in blood plasma with currently available treatments can take up to 80 days post-exposure 5.

Therapeutic dehydration of affected turtles has shown some promise, but turtles are slow to recover and treatment has been successful in only a portion of the animals 12, 19. Intravenous lipid emulsion therapy has the potential to reduce rehabilitation time, save resources, and increase survival of sea turtles and other marine animals experiencing brevetoxicosis.Ĭurrent treatment regimens of affected sea turtles include removal of the animal from the source of brevetoxins, dehydration therapy, and standard and supportive care (SSC) 12, 19. These types of fast-acting treatment plans are necessary for rehabilitation facilities that are already resource-limited. The dosage given here (25 mg/kg) was sufficient for turtles in this study, but the use of a higher dosage (50–100 mg/kg) for those animals experiencing severe symptoms may be considered. Nearly all symptoms were eliminated within 24–48 h, whereas using SSC, symptom elimination could take up to seven days or more. Additionally, survival rate of these patients was 94% (17/18), which is significantly higher than previous studies that used SSC and/or dehydration therapy (47% 46/99). We found that plasma brevetoxins declined faster compared to turtles that received only SSC. In total, nine (four subadults, one adult female, four adult males) loggerheads ( Caretta caretta), five (four juvenile, one adult female) Kemp’s ridleys ( Lepidochelys kempii), and four juvenile green turtles ( Chelonia mydas) were included in this study. Blood samples were collected at numerous intervals post-ILE delivery and analyzed for brevetoxins using enzyme-linked immunosorbent assays.

Upon admission, blood samples were collected, followed by immediate administration of 25 mg ILE/kg body mass (Intralipid® 20%) at 1 mL/min using infusion pumps.

Sea turtles exhibiting neurological symptoms related to brevetoxicosis were brought to rehabilitation from 2018–2019. Because red tide events occur annually in Florida, our objective was to test intravenous lipid emulsion (ILE) as a rapid treatment for brevetoxicosis in sea turtles and examine potential impacts on toxin clearance rates, symptom reduction, rehabilitation time, and survival rates. Traditional therapies for brevetoxicosis include standard and supportive care (SSC) and/or dehydration therapy however, these treatments are slow-acting and often ineffective. These dinoflagellates release lipophilic neurotoxins, known as brevetoxins, that bind to sodium channels and inhibit their inactivation, resulting in a variety of symptoms that can lead to mass sea turtle strandings. The southwest coast of Florida experiences annual red tides, a type of harmful algal bloom that results from high concentrations of Karenia brevis.

First lipid emulsion therapy used