Cardiac complications following tricyclic antidepressant overdose. Issues for monitoring policy.
Cardiac complications following tricyclic antidepressant overdose. Issues for monitoring policy.
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三环类抗抑郁药过量后的心脏并发症。
DOI：
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发表时间：
1985
期刊：
影响因子：
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通讯作者：
J. Hunt
中科院分区：
文献类型：
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作者：
R. Goldberg;R. Capone;J. Hunt
在美国，每年都有成千上万的人用三环类抗抑郁药毒害自己。虽然这些患者通常需要对潜在的心律失常进行心脏监测，但临床实践在监测时间方面是高度可变的。由于对资源的影响，澄清这个问题很重要。本研究回顾性回顾了75例成人服用过量三环类抗抑郁药后的监测实践和心脏并发症。患者接受的平均监测时间为61.7小时。绝大多数心电图变化，包括三次心脏骤停，出现在最初的24小时内。24小时内没有意识水平正常、心电图正常的患者出现任何明显的心律失常。基于这些数据和广泛的文献回顾，我们建议重新考虑三环类抗抑郁药物过量后心脏监测的现行指南。（jama 1985;254:1772-1775）
Thousands of people in the United States poison themselves with tricyclic antidepressants each year. While these patients often require cardiac monitoring for potential arrhythmias, clinical practice is highly variable in regard to the hours of monitoring required. Clarification of this issue is important because of the impact on resources. This study retrospectively reviews the monitoring practices and cardiac complications following tricyclic antidepressant overdose in 75 adults. The patients received an average of 61.7 hours of monitoring. The vast majority of electrocardiographic changes, including three cardiac arrests, appeared within the first 24 hours. No patient with a normal level of consciousness and a normal electrocardiogram for 24 hours went on to develop any significant arrhythmia. On the basis of these data and an extensive literature review, we propose that current guidelines for cardiac monitoring following tricyclic antidepressant overdose be reconsidered. ( JAMA 1985;254:1772-1775)