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

Abstract

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.

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Document Details

Document Type
Technical Report
Publication Date
Nov 01, 2014
Accession Number
ADA614348

Entities

People

  • Maria Castaneda
  • Shawn M. Varney
  • Susan Boudreau
  • Toni E. Vargas
  • Vikhyat S Bebarta

Organizations

  • United States Army Institute of Surgical Research

Tags

DTIC Thesaurus Topics

  • Air Force
  • Antidepressants
  • Arteries
  • Blood
  • Cardiovascular Diseases
  • Cardiovascular Physiological Phenomena
  • Emergency Medicine
  • Emulsions
  • Health Services
  • Heart Rate
  • Hypotension
  • Pain
  • Physiological Monitoring
  • Pilot Studies
  • Toxicity
  • Veins

Fields of Study

  • Medicine

Readers

  • Mental Health of Military Veterans with Posttraumatic Stress Disorder (PTSD): Risk Factors, Prevalence, Symptoms, and Treatment.
  • Molecular and Cellular Biochemistry
  • Trauma Surgery or Emergency Medicine.