title: Comparative Resuscitative Methods for Venlafaxine Toxicity in a Swine Model.
abstract: OBJECTIVE
  Venlafaxine overdose can lead to cardiovascular collapse that is difficult to resuscitate with traditional Advanced Cardiovascular Life Support protocols. Evidence has suggested that lipid emulsion infusion therapy has been successful in the treatment of antidepressant overdose. No studies have determined the optimal combination of lipid/advanced cardiovascular life support therapy for treatment.
  
  
  METHODS
  This study was a prospective, experimental, between subjects design with a swine model investigating the effectiveness of drug combinations administered with cardiopulmonary resuscitation (CPR) postvenlafexine overdose. Subjects were randomly assigned to 1 of eight groups containing seven subjects. The groups tested were CPR only and CPR with epinephrine alone; vasopressin alone; lipid alone; epinephrine and vasopressin; epinephrine and lipid; vasopressin and lipid; and epinephrine, vasopressin, and lipid. The outcomes of interest were survival odds and time to return of spontaneous circulation.
  
  
  RESULTS
  Results on these swine models indicate that the use of vasopressin coupled with lipids for venlafaxine overdose resulted in a higher survival rate when compared to the control group (p = 0.023). Groups receiving vasopressin experienced statistically faster times to return of spontaneous circulation than other groups (p = 0.019).
  
  
  CONCLUSIONS
  The results suggest that in swine models, the optimal treatment for venlafaxine overdose would include vasopressin with lipids.
authors.affiliation: Texas Tech & Texas Tech University Health Sciences System, 703 Flint Avenue, Lubbock, TX 79409.
authors.forename: Lawrence V
authors.initials: LV
authors.lastname: Fulton
authors.affiliation: U.S. Army Graduate Program in Anesthesia Nursing, Dunlap Hall, 3490 Forage Avenue, Fort Sam Houston, TX 78234.
authors.forename: Jason
authors.initials: J
authors.lastname: Aitken
authors.affiliation: U.S. Army Graduate Program in Anesthesia Nursing, Dunlap Hall, 3490 Forage Avenue, Fort Sam Houston, TX 78234.
authors.forename: John
authors.initials: J
authors.lastname: Avery
authors.affiliation: U.S. Army Graduate Program in Anesthesia Nursing, Dunlap Hall, 3490 Forage Avenue, Fort Sam Houston, TX 78234.
authors.forename: Brooke
authors.initials: B
authors.lastname: Kahl
authors.affiliation: U.S. Army Graduate Program in Anesthesia Nursing, Dunlap Hall, 3490 Forage Avenue, Fort Sam Houston, TX 78234.
authors.forename: Abisai
authors.initials: A
authors.lastname: Negron
authors.affiliation: U.S. Army Graduate Program in Anesthesia Nursing, Dunlap Hall, 3490 Forage Avenue, Fort Sam Houston, TX 78234.
authors.forename: Barbara
authors.initials: B
authors.lastname: Chavez
authors.affiliation: U.S. Army Graduate Program in Anesthesia Nursing, Dunlap Hall, 3490 Forage Avenue, Fort Sam Houston, TX 78234.
authors.forename: Nicole
authors.initials: N
authors.lastname: Iosett
authors.affiliation: U.S. Army Graduate Program in Anesthesia Nursing, Dunlap Hall, 3490 Forage Avenue, Fort Sam Houston, TX 78234.
authors.forename: Don
authors.initials: D
authors.lastname: Johnson
authors.affiliation: U.S. Army Graduate Program in Anesthesia Nursing, Dunlap Hall, 3490 Forage Avenue, Fort Sam Houston, TX 78234.
authors.forename: Joseph
authors.initials: J
authors.lastname: O'Sullivan
mesh_terms: D000818:Animals; D016887:Cardiopulmonary Resuscitation / Q000379:methods; D062787:Drug Overdose / Q000401:mortality / Q000628:therapy; D004359:Drug Therapy, Combination; D004837:Epinephrine / Q000627:therapeutic use; D005217:Fat Emulsions, Intravenous / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D016017:Odds Ratio; D011446:Prospective Studies; D011897:Random Allocation; D000068760:Serotonin and Noradrenaline Reuptake Inhibitors / Q000506:poisoning*; D015996:Survival Rate; D013552:Swine; D014662:Vasoconstrictor Agents / Q000627:therapeutic use*; D014667:Vasopressins / Q000627:therapeutic use*; D000069470:Venlafaxine Hydrochloride / Q000506:poisoning*
chemical_list: D005217:Fat Emulsions, Intravenous; D000068760:Serotonin and Noradrenaline Reuptake Inhibitors; D014662:Vasoconstrictor Agents; D014667:Vasopressins; D000069470:Venlafaxine Hydrochloride; D004837:Epinephrine