Post Your Cases > Intralipid in VT/VF arrest post drug ingestion

24 year old male ingested unknown substances and seized (in jail cell -- was arrested for drug purchase). Being rescucitated in ER unsuccessfully. Received over 20 amps of bicarb as pH was 6.54 and looked like TCA toxidrome. I gave 250 mls Intralipid over 1 hour. This may have helped, or kept him going until Bicarb could work. Shortly afterwards had Narrow Complex Tachycardia, and pH improved. He's now completed hypothermic treatment and is starting to rouse. I am the intensivist involved in his care.
January 12, 2008 | Unregistered CommenterDr. Jonathan Eisenstat
Jonathan,
Thanks so much for the post of this very hopeful case. Personally, i'm not a big believer in bicarb...i know this runs contrary to the belief of most toxicologists, but if you look at the bupropion case, and some others i've heard of, the lipid, not bicarb does the trick. now, assuming you'll have the results of a tox screen, (nd possibly access to some ECG strips), i would love to see you write this case up. it could be very important as well as very interesting and instructive. at the least let us know what the tox screen shows. regards,
guy
January 14, 2008 | Registered Commenter[Guy Weinberg]
One More Thing,
Jonathan, have you received the tox screen results yet??
guy
January 25, 2008 | Registered Commenter[Guy Weinberg]