Şimşek Meltem, Yıldırım Fatma, Şahin Habibenur, Akay Emine Banu
Department of Internal Medicine and Intensive Care, University of Health Sciences, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey.
Department of Internal Medicine, University of Health Sciences, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey.
Turk J Anaesthesiol Reanim. 2023 Feb;51(1):65-68. doi: 10.5152/TJAR.2022.21315.
In olanzapine intoxication alterations in consciousness defined as "agitation despite sedation" as well as cardiovascular and extrapyramidal side effects due to anticholinergic effects can be seen. In this case report, we aimed to present a patient who received a very high dose of olanzapine for suicide purposes benefited from intravenous lipid emulsion treatment (LET). A 20-year-old male patient, who received 840 mg of olanzapine for suicide, was brought to the emergency room, when the Glasgow Coma Scale was 5, he was intubated and given a single dose of activated charcoal. Later, he was admitted to the intensive care unit (ICU) intubated. The olanzapine level was measured as 653 μg L-1. The patient was started on LET and woke up at the sixth hour. In addition to the lack of strong evidence regarding the use of LET in olanzapine intoxication, it is seen that lipid therapy has been used successfully in patients. Compared with the cases in the literature, LET was successfully applied in our case, where the blood olanzapine level was very high. Although there is no evidence-based treatment in olanzapine intoxication, we believe that LET has a positive effect on neurological recovery and survival.
在奥氮平中毒时，可出现意识改变，表现为“镇静状态下躁动”，以及因抗胆碱能作用导致的心血管和锥体外系副作用。在本病例报告中，我们旨在介绍一名因自杀目的服用超大剂量奥氮平的患者，其从静脉注射脂质乳剂治疗（LET）中获益。一名20岁男性患者因自杀服用了840毫克奥氮平，被送往急诊室，当时格拉斯哥昏迷量表评分为5分，予以插管并给予单剂量活性炭。随后，他插管后被收入重症监护病房（ICU）。测得奥氮平水平为653μg/L。患者开始接受LET治疗，并在第六小时苏醒。除了关于LET用于奥氮平中毒缺乏有力证据外，还可见脂质疗法已在患者中成功应用。与文献中的病例相比，LET在我们这个血奥氮平水平非常高的病例中成功应用。尽管奥氮平中毒尚无循证治疗方法，但我们认为LET对神经恢复和生存有积极作用。
