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Charcoal hemoperfusion in an infant with supraventricular tachycardia and seizures secondary to amitriptyline

Mehmet Mutlu1, Gülay Karagüzel, Elif Bahat

  • 1Department of Pediatrics, Karadeniz Technical University Faculty of Medicine, Trabzon, Turkey.

Human & Experimental Toxicology
|May 22, 2010
PubMed

Insights

Severe tricyclic antidepressant (TCA) poisoning in an infant improved with charcoal hemoperfusion. This treatment effectively managed seizures and supraventricular tachycardia (SVT) caused by amitriptyline overdose.

Area of Science:

  • Toxicology
  • Pediatric Emergency Medicine
  • Cardiology

Background:

  • Tricyclic antidepressant (TCA) overdose is a frequent cause of poisoning with serious cardiovascular, respiratory, and neurological effects.
  • Amitriptyline, a common TCA, can lead to life-threatening toxicity in pediatric patients.

Observation:

  • An 18-month-old infant presented with unconsciousness, tachycardia, shallow breathing, and seizures following amitriptyline ingestion.
  • Electrocardiogram revealed supraventricular tachycardia (SVT), which persisted despite standard antiarrhythmic and anticonvulsive treatments.

Findings:

  • Charcoal hemoperfusion (HP) was initiated for 4 hours in the critically ill infant.
  • Following charcoal HP, the infant's clinical status significantly improved, with resolution of seizures and SVT.

Implications:

  • Charcoal hemoperfusion is a potentially effective treatment modality for severe amitriptyline intoxication in pediatric cases.
  • This case highlights the utility of extracorporeal methods in managing refractory TCA poisoning.
  • Early consideration of advanced interventions like charcoal HP may improve outcomes in severe pediatric poisonings.

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