Vernon D D, Banner W, Garrett J S, Dean J M
Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, UT 84113.
Crit Care Med. 1991 Apr;19(4):544-9. doi: 10.1097/00003246-199104000-00015.
Dopamine and norepinephrine were evaluated for treatment of hemodynamic compromise in amitriptyline intoxication. Fifteen anesthetized dogs underwent hemodynamic monitoring and amitriptyline intoxication, and received three infusion rates of dopamine (5, 15, and 30 micrograms/kg.min) and three infusion rates of norepinephrine (0.25, 0.5, and 1.0 micrograms/kg.min), sequentially, with hemodynamic measurements at each dose. Data were analyzed using repeated-measures analysis of variance; p less than .05 was considered significant.
Amitriptyline intoxication lowered cardiac output, peak left ventricular dP/dt, and mean arterial pressure (MAP). All doses of norepinephrine and the two higher doses of dopamine increased cardiac output, MAP, and peak left ventricular dP/dt during the intoxicated state. Both agents restored all variables to preintoxication values. Values obtained at the highest doses of the two drugs were not different for any variable.
Dopamine and norepinephrine each appeared effective in reversing amitriptyline-induced hemodynamic alterations.
评估多巴胺和去甲肾上腺素治疗阿米替林中毒所致血流动力学损害的效果。15只麻醉犬接受血流动力学监测并造成阿米替林中毒，依次接受三种多巴胺输注速率（5、15和30微克/千克·分钟）和三种去甲肾上腺素输注速率（0.25、0.5和1.0微克/千克·分钟），每种剂量时均进行血流动力学测量。采用重复测量方差分析对数据进行分析；p值小于0.05被视为具有统计学意义。
阿米替林中毒降低了心输出量、左心室最大dp/dt和平均动脉压（MAP）。所有剂量的去甲肾上腺素以及两种较高剂量的多巴胺均能在中毒状态下增加心输出量、MAP和左心室最大dp/dt。两种药物均可使所有变量恢复至中毒前水平。两种药物最高剂量时所测得的任何变量值均无差异。
多巴胺和去甲肾上腺素在逆转阿米替林所致血流动力学改变方面似乎均有效。
