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Amitriptyline poisoning in a 2‐year old
Author(s) -
DEEGAN CATHERINE,
O'BRIEN KAY
Publication year - 2006
Publication title -
pediatric anesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.704
H-Index - 82
eISSN - 1460-9592
pISSN - 1155-5645
DOI - 10.1111/j.1460-9592.2005.01624.x
Subject(s) - medicine , ventricular fibrillation , ventricular tachycardia , cardiopulmonary resuscitation , coma (optics) , anesthesia , tachycardia , resuscitation , amitriptyline , cardiology , physics , optics
Summary We describe a case of a 2‐year‐old boy who ingested 35 mg·kg −1 of amitriptyline. He developed central nervous system toxicity, as demonstrated by coma and seizures and cardiac toxicity (cardiac arrest) within 1 h of ingestion. The cardiac toxicity was refractory to standard therapy. His cardiac rhythm alternated between ventricular tachycardia and pulseless ventricular tachycardia/ventricular fibrillation for a period of 17 h. Following prolonged cardiopulmonary resuscitation and aggressive supportive management, the patient recovered both cardiovascularly and neurologically. An echocardiogram and MRI brain were subsequently performed and were normal. The patient was discharged 2 weeks later with normal cognitive, behavioral and motor function. We discuss the benefit of prolonged and effective cardiopulmonary resuscitation in the management of this potentially fatal poisoning.