In a review of pooled cases of diphenhydramine toxicity refractory to traditional resuscitation methods, which parameters showed improvement after lipid emulsion therapy?
In the patients who received LET, the mean arterial pressure (MAP) increased in MAP 37±17.5mm Hg compared to a decrease by 4.5 ± 11.5 mm Hg in those who did not receive LET. The increase in MAP in those who received LET was statistically significantly greater than in those who did not receive LET. There were some other possible trends towards improved cardiac stability. The QRS narrowed by 29 ± 33.9 ms (no LET group) vs 68 ± 49.5 ms (LET group) and QTc by 168.5 ± 126.75 ms (no LET group) vs 134 ± 88 ms (LET group). However, despite trending towards improvement, QRS narrowing and QT narrowing were not statistically significant.
Clemons J, Jandu A, Stein B, Chary M. Efficacy of lipid emulsion therapy in treating cardiotoxicity from diphenhydramine ingestion: a review and analysis of case reports. Clin Toxicol (Phila). 2022 Feb 16:1-9.
Contributed by: Dawn Sollee, PharmD DABAT & Molly Stott, PharmD on behalf of Florida/USVI Poison Information Center-Jacksonville