Intravenous Lipid Emulsion Therapy Does Not Improve Hypotension Compared to Sodium Bicarbonate for Tricyclic Antidepressant Toxicity: A Randomized, Controlled Pilot Study in a Swine Model
ARMY INST OF SURGICAL RESEARCH SAN ANTONIO TX
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Tricyclic antidepressants TCAs are highly lipophilic medications used to treat posttraumatic stress disorder and chronic pain. Intravenous lipid emulsion ILE is a recent antidote for lipophilic drug overdose with unclear effectiveness. ILE has been studied in TCA overdose in small animals, and cases are reported in humans, but controlled studies in a larger animal model are lacking. Given the high lipophilicity of amitriptyline, a TCA, the hypothesis was that ILE would be more effective than the standard antidote sodium bicarbonate in improving amitriptyline-induced hypotension. The objective was to determine if ILE improved hypotension defined by a mean arterial pressure MAP 60 baseline compared to sodium bicarbonate for amitriptyline overdose in a critically ill porcine model.
- Medicine and Medical Research