title: Use of an Intravascular Heat Exchange Catheter and Intravenous Lipid Emulsion for Hypothermic Cardiac Arrest After Cyclobenzaprine Overdose.
abstract: In this case report, a 22-year-old male developed severe hypothermia after an accidental overdose of cyclobenzaprine. During transport, the patient developed cardiac arrest. He received active rewarming measures, including pleural lavage, gastric lavage, an intravascular heat exchange catheter, and cardiopulmonary bypass. Intravenous lipid emulsion (ILE) was also administered. A discussion of cyclobenzaprine toxicity, hypothermia, ILE, and accidental hypothermic cardiac arrest follows.
authors.affiliation: 1 Department of Emergency Medicine, Newark Beth Israel Medical Center , Newark, New Jersey.
authors.forename: Michael S
authors.initials: MS
authors.lastname: Westrol
authors.affiliation: 2 Department of Pharmacy, Robert Wood Johnson University Hospital , New Brunswick, New Jersey.
authors.forename: Nadia I
authors.initials: NI
authors.lastname: Awad
authors.affiliation: 2 Department of Pharmacy, Robert Wood Johnson University Hospital , New Brunswick, New Jersey.
authors.forename: Patrick J
authors.initials: PJ
authors.lastname: Bridgeman
authors.affiliation: 3 Robert Wood Johnson Medical School at Rutgers, The State University of New Jersey , New Brunswick, New Jersey.
authors.forename: Erika
authors.initials: E
authors.lastname: Page
authors.affiliation: 4 Department of Emergency Medicine, Robert Wood Johnson Medical School at Rutgers, The State University of New Jersey , New Brunswick, New Jersey.
authors.forename: Jonathan V
authors.initials: JV
authors.lastname: McCoy
authors.affiliation: 4 Department of Emergency Medicine, Robert Wood Johnson Medical School at Rutgers, The State University of New Jersey , New Brunswick, New Jersey.
authors.forename: Janos
authors.initials: J
authors.lastname: Jeges
mesh_terms: D000639:Amitriptyline / Q000031:analogs & derivatives* / Q000494:pharmacology; D002315:Cardiopulmonary Bypass / Q000379:methods*; D016887:Cardiopulmonary Resuscitation / Q000379:methods; D062787:Drug Overdose / Q000150:complications*; D005217:Fat Emulsions, Intravenous / Q000008:administration & dosage*; D006323:Heart Arrest / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D006801:Humans; D007035:Hypothermia / Q000139:chemically induced / Q000150:complications; D008297:Male; D019999:Pharmaceutical Solutions / Q000008:administration & dosage; D017694:Rewarming / Q000295:instrumentation / Q000379:methods; D014149:Tranquilizing Agents / Q000494:pharmacology; D016896:Treatment Outcome; D062666:Vascular Access Devices; D055815:Young Adult
chemical_list: D005217:Fat Emulsions, Intravenous; D019999:Pharmaceutical Solutions; D014149:Tranquilizing Agents; D000639:Amitriptyline; C004704:cyclobenzaprine