Department of Anaesthesiology, Copenhagen University Hospital Bispebjerg, Copenhagen, Denmark.
Department of Veterinary Clinical Sciences, Faculty of Health and Medical Sciences, University Hospital for Companion Animals, University of Copenhagen, Copenhagen, Denmark.
Basic Clin Pharmacol Toxicol. 2018 Apr;122(4):442-447. doi: 10.1111/bcpt.12931. Epub 2017 Dec 27.
Coated activated charcoal haemoperfusion (CAC-HP) does not reduce the plasma concentration in amitriptyline (AT)-poisoned pigs. The aim of this non-blinded, randomized, controlled animal trial was to determine if CAC-HP reduces the pathological ECG changes caused by AT poisoning. Fourteen female Danish Landrace pigs (mean weight 27.7 kg, range 20-35 kg (CAC-HP) and 24.4 kg, range 18-30 kg (control group, CG), n = 7 in each group) were included. After randomization, the pigs were anaesthetized and intravenously poisoned with AT. The intervention group underwent 4 hr of CAC-HP plus standard care (oral activated charcoal). Intervention was compared to standard care alone. From each pig, a 12-lead ECG and haemodynamic variables were obtained at baseline, at full AT loading dose, before and during CAC-HP. Baseline ECG variables (RR, PR, QRS, QTc, QTp, QTe, TpTe and TpTe/QT) for lead II, v2 and v5 were not significantly different (F = 0.035-0.297, p-values 0.421-0.919). Differences within groups over time and between groups were tested by anova repeated measures. For all variables, the time-plus-group level of significance revealed a p-value > 0.05. Severe cardiovascular arrhythmias occurred in both groups with 3 in the CAC-HP group versus 1 incident with premature death in the CG. The attenuating effect of CAC-HP to orally instilled activated charcoal alone on AT-induced ECG alterations did not differ significantly. We conclude that the use of modern CAC-HP as an adjunctive treatment modality in AT-poisoned pigs is inadequate.
包裹活性炭血液灌流（CAC-HP）不能降低阿米替林（AT）中毒猪的血浆浓度。本非盲、随机、对照动物试验的目的是确定 CAC-HP 是否减少 AT 中毒引起的病理性心电图变化。纳入 14 头雌性丹麦长白猪（平均体重 27.7kg，范围 20-35kg（CAC-HP 组）和 24.4kg，范围 18-30kg（对照组，CG），每组 n = 7）。随机分组后，猪被麻醉并静脉内给予 AT 中毒。干预组接受 4 小时 CAC-HP 加标准护理（口服活性炭）。干预与单独标准护理进行比较。从每头猪获得 12 导联心电图和血流动力学变量，在基线、AT 全负荷剂量、CAC-HP 之前和期间。II 导联、v2 和 v5 的基线心电图变量（RR、PR、QRS、QTc、QTp、QTe、TpTe 和 TpTe/QT）无显著差异（F = 0.035-0.297，p 值 0.421-0.919）。通过重复测量方差分析测试组内随时间的差异和组间差异。对于所有变量，时间加组水平的显著性揭示 p 值>0.05。两组均发生严重心血管心律失常，CAC-HP 组 3 例，CG 组 1 例并发过早死亡。与单独口服活性炭相比，CAC-HP 对 AT 诱导的心电图改变的减弱作用无显著差异。我们得出结论，在 AT 中毒的猪中，现代 CAC-HP 作为辅助治疗方式的应用是不足的。
