Terlipressin as an adjunct vasopressor in refractory hypotension after tricyclic antidepressant intoxication

Zuidema, Xander; Dünser, Martin W; Wenzel, Volker; Rozendaal, Frans W; de Jager, Cornelis P C (2006). Terlipressin as an adjunct vasopressor in refractory hypotension after tricyclic antidepressant intoxication. Resuscitation, 72(2), pp. 319-23. Shannon: Elsevier Science Ireland 10.1016/j.resuscitation.2006.07.005

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AIM OF STUDY: To report the management of cardiovascular failure refractory to standard catecholamine therapy with terlipressin in a patient with tricyclic antidepressant (TCA) intoxication. CASE REPORT: A 41-year-old woman, with suicidal ingestion of 11.25 g amitriptyline and 1500 mg diclofenac, was admitted to the emergency department. After 30 min in ventricular fibrillation, with ongoing CPR, she regained a potentially perfusing rhythm, but with hypotension refractory to standard catecholamine therapy with adrenaline, 2 microg/kg/min (norepinephrine); adrenaline, 1 microg/kg/min (epinephrine) until 55 min after admission. An injection of 1 mg terlipressin restored mean arterial blood pressure >65 mmHg within 10 min. Ten hours after admission to the intensive care unit, catecholamine support could be withdrawn because of a stable haemodynamic state. Within 7 days, all organ function recovered, and the patient regained full neurological function. CONCLUSIONS: Successful management of cardiovascular failure with terlipressin after TCA intoxication refractory to catecholamines suggests a potential role for terlipressin as an adjunct vasopressor in severely hypotensive patients.

Item Type:	Journal Article (Further Contribution)
Division/Institute:	04 Faculty of Medicine > Department of Intensive Care, Emergency Medicine and Anaesthesiology (DINA) > Clinic of Intensive Care
UniBE Contributor:	Dünser, Martin Wolfgang
ISSN:	0300-9572
ISBN:	17123689
Publisher:	Elsevier Science Ireland
Language:	English
Submitter:	Factscience Import
Date Deposited:	04 Oct 2013 14:49
Last Modified:	05 Dec 2022 14:15
Publisher DOI:	10.1016/j.resuscitation.2006.07.005
PubMed ID:	17123689
Web of Science ID:	000244022400022
URI:	https://boris.unibe.ch/id/eprint/20419 (FactScience: 3710)