Intravenous Fat Emulsion (IFE) Improvement of Qt-Interval in Tricyclic Antidepressant Overdose

Authors

  • Ryan Mason FAAEM Division of Emergency Medicine, University of Washington, Seattle, WA, USA
  • William Hurley FAAEM Division of Emergency Medicine, University of Washington, Seattle, WA, USA
  • Richard B. Utarnachitt FAAEM Division of Emergency Medicine, University of Washington, Seattle, WA, USA

DOI:

https://doi.org/10.17140/EMOJ-2-124

Keywords:

Tricyclic Acid Overdose, Intravenous Fat Emulsion Therapy

Abstract

Here we report a case of a 62-year-old female with a potentially lethal ingestion of a tricyclic antidepressant (nortriptyline) refractory to conventional therapy. In the emergency department, she was profoundly hypotensive and significantly acidotic. She received several sodium bicarbonate boluses followed by continuous sodium bicarbonate infusion in addition to multiple vasopressors. Despite these measures, the patient remained dangerously hypotensive with a prolonged QT interval. Lipid emulsion was started with a bolus and infusion. Subsequently, the patient successfully weaned off pressor support and her QT interval normalized. After a short hospital course, patient was discharged with only moderate cognitive impairment.

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Published

2016-05-17

How to Cite

Ryan Mason, William Hurley, & Richard B. Utarnachitt. (2016). Intravenous Fat Emulsion (IFE) Improvement of Qt-Interval in Tricyclic Antidepressant Overdose. Emergency Medicine, 2(2), 23–26. https://doi.org/10.17140/EMOJ-2-124

Issue

Vol. 2 No. 2 (2016): Volume 2 Issue 2 2016

Section

Articles

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