title: Arterial blood gas analysis and the outcome of treatment in tricyclic antidepressants poisoned patients with benzodiazepine coingestion.
abstract: Background. Poisoning with tricyclic antidepressants (TCAs) is still a major concern for emergency physicians and intensivists. Concomitant ingestion of other psychoactive drugs especially benzodiazepines with TCAs may make this clinical situation more complex. This study aimed to compare the arterial blood gas (ABG) values and the outcome of treatment in patients with coingestion of TCA and benzodiazepine (TCA + BZD) poisoning and TCA poisoning alone. Methods. In this cross-sectional study which was carried out in a tertiary care university hospital in Iran, clinical and paraclinical characteristics of one hundred forty TCA only or TCA + BZD poisoned patients (aged 18-40 years) were evaluated. ABG analysis was done on admission in both groups. Outcomes were considered as survival with or without complication (e.g., intubation) and the frequency of TCA poisoning complications. Results. Arterial pH was significantly lower in TCA + BZD poisoning group compared with TCA only poisoning group (7.34 ± 0.08 and 7.38 ± 0.08, resp.; P = 0.02). However, other complications such as seizure, and the need for the endotracheal intubation were not significantly different. All patients in both groups survived. Conclusions. Concomitant TCA plus BZD poisoning may make the poisoned patients prone to a lower arterial pH level on hospital admission which may potentially increases the risk of cardiovascular complications in TCA poisoning.
authors: Department of Anesthesiology and Critical Care, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
authors: Ahmad
authors: A
authors: Yaraghi
authors: Isfahan Clinical Toxicology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
authors: Nastaran
authors: N
authors: Eizadi-Mood
authors: Department of Clinical Toxicology, Noor and Ali Asghar (PBUH) University Hospital, Isfahan University of Medical Sciences, Isfahan, Iran.
authors: Maryam
authors: M
authors: Katani
authors: Department of Clinical Pharmacy and Pharmacy Practice, School of Pharmacy and Pharmaceutical Sciences, Isfahan University of Medical Sciences, Isfahan, Iran.
authors: Shadi
authors: S
authors: Farsaei
authors: Department of Clinical Toxicology, Noor and Ali Asghar (PBUH) University Hospital, Isfahan University of Medical Sciences, Isfahan, Iran.
authors: Mahrang
authors: M
authors: Hedaiaty
authors: Department of Clinical Toxicology, Noor and Ali Asghar (PBUH) University Hospital, Isfahan University of Medical Sciences, Isfahan, Iran.
authors: Seyyed Mohammad Mahdy
authors: SM
authors: Mirhosseini
authors: Department of Clinical Toxicology, Noor and Ali Asghar (PBUH) University Hospital, Isfahan University of Medical Sciences, Isfahan, Iran.
authors: Elham
authors: E
authors: Beheshtian
authors: Isfahan Clinical Toxicology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
authors: Ali Mohammad
authors: AM
authors: Sabzghabaee
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