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  • Dramatic resuscitation with Intralipid in an epinephrine unresponsive cardiac arrest following overdose of amitriptyline and propranolol

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CASE REPORT
Dramatic resuscitation with Intralipid in an epinephrine unresponsive cardiac arrest following overdose of amitriptyline and propranolol
  1. Philippe Le Fevre1,
  2. Mark Gosling2,
  3. Keyur Acharya1,
  4. Andrew Georgiou1
  1. 1Critical Care Unit, Royal United Hospital, Bath, Somerset, UK
  2. 2Department of Medical Education/Emergency Medicine, Royal United Hospital, Bath, Somerset, UK
  1. Correspondence to Dr Mark Gosling, markgosling{at}nhs.net

Summary

Amitriptyline and propranolol are life threatening in overdose. The efficacy of intravenous lipid emulsion (ILE) in tricyclic antidepressant and propranolol overdose is unclear. We report a dramatic response to ILE following pulseless electrical activity arrest due to mixed amitriptyline and propranolol overdose.

https://doi.org/10.1136/bcr-2016-218281

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    Footnotes

    • Acknowledgements Thank you to the patient for agreeing to the case report. Additionally, thank you to everyone in the Royal United Hospital Critical Care Unit and Emergency Department who helped with the patient's care.

    • Contributors AG (Consultant) and PLF (Specialty Doctor) had the initial idea for the case report after managing the patient in the emergency department and the critical care unit, and having made the decision to give the Intralipid as described in the report. PLF and MG carried out literature searches. The article was written by PLF, MG and KA with significant alterations and additions by AG. AG is the guarantor and controlled the decision to publish. The patient was initially looked after by AG (Consultant) and PLF (Specialty Doctor) in the acute phase of their illness. AG continued to oversee the patient's care in the following 48 hours with the help of KA (Specialty Doctor) and MG (SHO). KA (Specialty Doctor) and MG (SHO) sought consent from the patient to publish the report and followed the patient's progress until hospital discharge.

    • Competing interests None declared.

    • Patient consent Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.