使用碳酸氢钠治疗碱中毒患者三环类抗抑郁药引起的心律失常。
Use of sodium bicarbonate to treat tricyclic antidepressant-induced arrhythmias in a patient with alkalosis.
作者信息
Molloy D W, Penner S B, Rabson J, Hall K W
出版信息
Can Med Assoc J. 1984 Jun 1;130(11):1457-9.
Sodium bicarbonate has been recommended for the treatment of arrhythmias induced by tricyclic antidepressants. It is unclear, however, whether this therapy is effective only in the presence of acidosis. A case is presented in which there was an immediate response to sodium bicarbonate in three episodes of ventricular tachycardia despite the presence of alkalosis on two of the three occasions. Given the poor response to conventional therapy of arrhythmias induced by tricyclic antidepressants the use of sodium bicarbonate may be reasonable even in the presence of alkalosis. However, in the presence of pre-existing respiratory or metabolic alkalosis, such therapy is not without risk, and it is suggested that it be reserved for life-threatening situations when the arrhythmia has failed to respond to hyperventilation or antiarrhythmics or both.
碳酸氢钠已被推荐用于治疗三环类抗抑郁药所致的心律失常。然而，尚不清楚这种治疗是否仅在存在酸中毒时才有效。本文报告了1例患者，尽管在3次室性心动过速发作中有2次存在碱中毒，但给予碳酸氢钠后均立即出现反应。鉴于三环类抗抑郁药所致心律失常对传统治疗反应不佳，即使存在碱中毒，使用碳酸氢钠可能也是合理的。然而，在已有呼吸性或代谢性碱中毒的情况下，这种治疗并非没有风险，建议仅在心律失常对过度通气或抗心律失常药物或两者均无反应的危及生命的情况下使用。
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