Goldman M J, Mowry J B, Kirk M A
Department of Emergency Medicine, Allegheny General Hospital, Pittsburgh, Pennsylvania 15212-4772, USA.
J Emerg Med. 1997 Mar-Apr;15(2):183-6. doi: 10.1016/s0736-4679(96)00345-9.
A 16-yr-old male attempted suicide by ingesting approximately 4000 mg of flecainide. He developed coma, hypotension, and ventricular tachycardia. In addition to supportive care and antidysrhythmics, he received intravenous sodium bicarbonate for the wide complex dysrhythmia. Animal studies and anecdotal human experience have suggested that increasing the extracellular sodium improves cardiac conduction in flecainide toxicity. The patient's QRS narrowed immediately following sodium bicarbonate infusion. Sodium bicarbonate may be useful in the treatment of widened QRS and ventricular ectopy resulting from flecainide toxicity.
一名16岁男性摄入约4000毫克氟卡尼企图自杀。他出现了昏迷、低血压和室性心动过速。除了支持治疗和抗心律失常药物外,他还因宽QRS波型心律失常接受了静脉注射碳酸氢钠治疗。动物研究和零星的人体经验表明,增加细胞外钠离子浓度可改善氟卡尼中毒时的心脏传导。在输注碳酸氢钠后,患者的QRS波立即变窄。碳酸氢钠可能有助于治疗氟卡尼中毒导致的QRS波增宽和室性早搏。