Document Detail


Hypertonic sodium bicarbonate for Taxus media-induced cardiac toxicity in swine.
MedLine Citation:
PMID:  11874772     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To determine whether intravenous (IV) hypertonic sodium bicarbonate is effective in the reversal of QRS widening associated with severe Taxus intoxication. METHODS: Seventeen anesthetized and instrumented swine were poisoned with an IV extract of Taxus media until doubling of the QRS interval on electrocardiography was achieved. After poisoning (time zero), the animals received either 4 mL/kg IV 8.4% sodium bicarbonate (experimental group; 6 animals), a similar volume of 0.7% NaCl in 10% mannitol (mannitol group; 6 animals), or nothing (control group; 5 animals). The main outcome parameter was QRS duration. Secondary outcome parameters were mean arterial pressure (MAP), heart rate (HR), and cardiac index (CI = cardiac output/kg). Additionally, arterial pH, partial pressure of carbon dioxide (pCO(2)), and plasma-ionized calcium, sodium, and potassium were monitored. RESULTS: Taxus toxicity, defined as a 100% increase in QRS duration, was produced in all animals. The animals were similar in regard to baseline and time 0 physiologic parameters as well as amount of Taxus media extract administered. From times 5 through 30 minutes, following assigned treatment, significant increases in QRS duration were detected in the experimental and mannitol groups compared with the control group. A significant lowering of MAP was found in the experimental group compared with the control group. No significant difference between groups was noted in HR or CI. The swine treated with hypertonic sodium bicarbonate had a statistically significant increase in pH, plasma sodium concentration, and base excess compared with the other groups. CONCLUSIONS: Hypertonic sodium bicarbonate was ineffective in reversing the widening of QRS interval associated with Taxus poisoning in this swine model.
Authors:
Anne-Michelle Ruha; David A Tanen; Kimberlie A Graeme; Steven C Curry; Mary Beth Miller; Richard Gerkin; Christine G Reagan; Tedd A Brandon
Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Academic emergency medicine : official journal of the Society for Academic Emergency Medicine     Volume:  9     ISSN:  1069-6563     ISO Abbreviation:  Acad Emerg Med     Publication Date:  2002 Mar 
Date Detail:
Created Date:  2002-03-04     Completed Date:  2002-04-24     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9418450     Medline TA:  Acad Emerg Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  179-85     Citation Subset:  IM    
Affiliation:
Department of Medical Toxicology, Good Samaritan Regional Medical Center, Phoenix, AZ 85006, USA. michelle.ruha@bannerhealth.com
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MeSH Terms
Descriptor/Qualifier:
Animals
Blood Pressure / drug effects
Calcium / blood
Disease Models, Animal
Electrocardiography / drug effects*
Heart Rate / drug effects*
Hydrogen-Ion Concentration / drug effects
Hypertonic Solutions / administration & dosage
Infusions, Intravenous
Male
Mannitol / pharmacology
Poisoning / drug therapy*
Potassium / blood
Sodium / blood
Sodium Bicarbonate / administration & dosage*
Swine
Taxus / poisoning*
Chemical
Reg. No./Substance:
0/Hypertonic Solutions; 144-55-8/Sodium Bicarbonate; 69-65-8/Mannitol; 7440-09-7/Potassium; 7440-23-5/Sodium; 7440-70-2/Calcium

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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