Document Detail

Adverse cardiac events in ICU patients with presumptive antidepressant overdose.
MedLine Citation:
PMID:  14652803     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Antidepressants account for most poison-related admissions to intensive care units. In selected patients with confirmed cyclic antidepressant intoxication a QRS interval <0.1 s in the ECG limb leads during the first six hours excludes adverse cardiac events. However, the incidence of cardiac events and the value of ECG criteria have never been assessed prospectively on patients with presumed antidepressant overdose.
AIM: To assess ingested drugs, adverse cardiac events, and ECG findings in ICU patients with a presumptive diagnosis of antidepressant overdose.
METHODS: 103 consecutive patients with a presumptive diagnosis of antidepressant overdose were enrolled and prospectively followed. Outcome criteria were arrhythmias, mortality, and duration of the ICU stay.
RESULTS: Mixed intoxication was identified in 66 (64%) patients. Tricyclic antidepressants were found in 88 (85%), and serotonin-reuptake inhibitors in 25 (24%) patients. Mean APACHE II score was 9.5 (SD +/- 6.0). Arrhythmias affected 15 (15%) and cardiopulmonary resuscitation was performed on 4 (4%) patients. Three patients (3%) died in the ICU. Median duration of the ICU stay was 1 day (12 hours to 6 days). Adverse cardiac events affected patients with normal and prolonged QRS interval at study entry.
CONCLUSIONS: Mixed intoxication is present in most ICU patients with suspected antidepressant overdose. There is a considerable risk for adverse cardiac events, even in the presence of normal ECG recordings within the first six hours after hospital admission.
C A Arranto; C Mueller; P R Hunziker; S C Marsch; U Eriksson
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Swiss medical weekly     Volume:  133     ISSN:  1424-7860     ISO Abbreviation:  Swiss Med Wkly     Publication Date:  2003 Sep 
Date Detail:
Created Date:  2003-12-03     Completed Date:  2004-03-11     Revised Date:  2011-02-15    
Medline Journal Info:
Nlm Unique ID:  100970884     Medline TA:  Swiss Med Wkly     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  479-83     Citation Subset:  IM    
Division of Intensive Care, Basel University Hospital, Switzerland.
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MeSH Terms
Aged, 80 and over
Antidepressive Agents / blood,  poisoning*
Arrhythmias, Cardiac / blood,  chemically induced*,  therapy
Intensive Care Units
Length of Stay
Middle Aged
Prospective Studies
Treatment Outcome
Reg. No./Substance:
0/Antidepressive Agents

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