ABSTRACT Sodium bicarbonate administration is widely recommended as the first line treatment in TCA intoxication. The comparison between methods of sodium bicarbonate administration has not been established in TCA poisoning. This randomized prospective study was performed in the Toxicology research center of Loghman-Hakim Hospital, Tehran, Iran. We compared efficacy of drip infusion versus bolus administration of sodium bicarbonate on treatment of TCA poisoning. 80 patients who met the inclusion criteria, divided into two groups of drip infusion sodium bicarbonate-treated and bolus administration sodium bicarbonate-treated group. 2 meq/kg/8h of sodium bicarbonate 7.5% intravenously for the first 24 hours until resolution of ECG changes and reaching 7.45-7.55 PH reports. Questioners were filled out by physicians including demographic, clinical and paraclinical data in order to compare patients‘ outcomes between two groups of treatment. There were 45 (56.3%) females with mean age 34.22 years and 35 males with mean age 36.71 years. More patients, after 8 hours, were conscious in DI. (P value < 0.05) and also this group had normal EKG findings during and after 16 hours (P values = 0.013/0.005). There were no significant differences in Comparison of patients’ ABG outcomes between two methods of treatment. In our study of TCA overdose, we found that more patients were conscious in drip infusion group only after 8 hours. Normal EKG changes were noted at 16 and 24 hours with drip infusion group at 16 and 24 hours. From this group of patients it appears that drip infusion group helps certain parameters more than bolus administration. The findings of this report show the need for further trial studies, which could identify the effective method.
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