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Use of Intralipid in tricyclic overdose
Report by: Dianne Tabone, ST4 Emergency Medicine
Search checked by: Lee Helliwell, SpR in Emergency Medicine
Institution: Royal Preston Hospital, Preston, UK
In [an adult with tricyclic anti-depressant poisoning] is [intravenous lipid mulsion / Intralipid / Liposyn II] benificial [in resistant hypotension and refractory dysrhythmias]?
A patient with tricyclic antidepressant overdose is treated in the Emergency Department. He is hypotensive and drowsy and has prolonged QTc on electrocardiogram. Blood gas shows metabolic acidosis. He is given intravenous fluids and sodium bicarbonate boluses until his pH becomes 7.6. However, he remains hypotensive. His rhythm then changes to VT. You remember that intravascular lipid emulsion (intralipid) has been used for overdoses of lipid-soluble drugs and you wonder whether it could be effective in this patient.
MEDLINE 1966 to Week 2 January 2010 …
Competing interests None.
Provenance and peer review Commissioned; not externally peer reviewed.