Jarnvig I L, Eriksen H O
Rigshospitalet, Anaestesiafdelingen, København.
Ugeskr Laeger. 1991 Mar 11;153(11):793-4.
A case of "adult respiratory distress syndrome" after amitriptyline overdosage is reported. Amitriptyline is rapidly absorbed from the intestinal tract and the drug is concentrated in the tissues, particularly the brain, heart and lungs. It is suggested that in large quantities it may inhibit surfactant production and thus cause the clinical picture described. The ventilatory treatments are discussed. It seems that inversed ratio ventilation (IRV) has something to offer, avoiding the use of high oxygen fractions in inspired air and high peak airway pressures. Our patient improved with IRV.
报告了一例阿米替林过量服用后出现“成人呼吸窘迫综合征”的病例。阿米替林可迅速从肠道吸收，且药物在组织中蓄积，尤其是脑、心脏和肺。提示大量服用时可能抑制表面活性物质的产生，从而导致所述的临床表现。文中讨论了通气治疗方法。反比通气（IRV）似乎有一定作用，可避免在吸入气体中使用高氧浓度和避免产生较高的气道峰压。我们的患者采用反比通气后病情好转。
