Intravenous Fat Emulsion Therapy Versus Sodium Bicarbonate Effect on Hypotension and QRS Measurement in a Swine Model (Sus scrofa) of Diphenhydramine Toxicity

Abstract

Obj:Compare IV fat emulsion(IFE) and sodium bicarbonate(SB) in critically ill diphenhydramine(DPH) swine to determine which better improves hypotension(hypo). Method:Swine 45-55kg infused with DPH 1mg/kg/min IV until MAP fell to 60% of baseline (BL), randomized to IFE or SB. Measured HR, SBP, MAP, CO, SVR, & SvO2. Labs for pH, pCO2, bicarb, lactate, & DPH level. DPH level found by liquid chromatography. Results:24 swine, 12 each to IFE & SB group. At BL, vital signs similar in each group. IFE & SB group had similar amt of DPH to hypo(IFE: 31.21mg/kg; SB: 33.28mg/kg). IFE to hypo at mean 32:13min; SB at 34:08min. Post hypo, no difference in IFE & SB groups for CO, SVR, SvO2, QRS, or QTc; though, better HR in SB, SBP in IFE, & MAP in IFE. IFE group died at mean 12:33min; SB at 07:48min. One IFE and two SB pigs survived. Mean total serum DPH levels end of study similar. Mean DPH in lipid layer was 6.8mcg/mL, in aqueous layer 8.6mcg/mL. Conc:No difference in hypo between IFE & SB. IFE didn't improve QRS widening in DPH toxic swine. DPH level similar in aqueous & lipid layers.

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Document Details

Document Type
Technical Report
Publication Date
Nov 13, 2012
Accession Number
ADA578611

Entities

People

  • Brett Pearce
  • Maria Castaneda
  • Shawn Varney
  • Susan Boudreau
  • Toni Vargas
  • Vikhyat

Organizations

  • 59th Medical Wing

Tags

DTIC Thesaurus Topics

  • Air Force
  • Animals
  • Antidotes
  • Cardiovascular Physiological Phenomena
  • Emergency Medicine
  • Emulsions
  • Feasibility Studies
  • Health Services
  • Heart Rate
  • Hypotension
  • Liquid Chromatography
  • Measurement
  • Medical Personnel
  • Statistical Analysis
  • Therapy
  • Toxicity
  • Vital Signs

Fields of Study

  • Medicine

Readers

  • Analytical Mechanics
  • Cardiovascular Physiology