Case report: Management of an unknown TCA diagnosis: The importance of rapid diagnosis and the use of CVVHDF in toxin elimination

Abstract

This case report highlights the effective medical management of a 27-year-old woman in critical condition due to an unknown medication overdose. The patient's initial condition at the emergency department (ED) indicated TCA (Tricyclic antidepressant) toxicity, which implied a poor prognosis based on clinical presentation and measurable criteria. The patient's systemic collapse was managed emergently in accordance with the TOXBASE guidelines. Additional supportive measures, including Continuous Venovenous Hemodiafiltration (CVVHDF), were employed in this severe case. Swift therapeutic interventions administered in the Emergency Department (ED) and Intensive Care Unit (ICU) resulted in enhanced clinical outcomes and improved haemodynamic status within five days. The patient successfully achieved complete clinical recovery without any neurological sequelae. She was discharged home within a week. This case underscores the importance of early recognition and highlights the utilisation of CVVHDF as an adjunct therapy in the advent of a lethal TCA overdose.

Keywords

• Tricyclic antidepressant toxicity
• Continuous venovenous
• Hemodiafiltration
• Overdose