Role of intravenous lipid emulsions in the management of calcium channel blocker and beta-blocker overdose: 3 years experience of a university hospital

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SEBE A., DİŞEL N. R., Akpinar A. A., KARAKOÇ E.

POSTGRADUATE MEDICINE, vol.127, no.2, pp.119-124, 2015 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 127 Issue: 2
  • Publication Date: 2015
  • Doi Number: 10.1080/00325481.2015.1012480
  • Journal Name: POSTGRADUATE MEDICINE
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Page Numbers: pp.119-124
  • Keywords: Intravenous lipid therapy, calcium channel blocker overdose, beta-blocker overdose, emergency, poisoning, FAT EMULSION, SUCCESSFUL RESUSCITATION, TOXICITY, INFUSION, MODEL, THERAPY
  • Çukurova University Affiliated: Yes

Abstract

Objectives: The objective of this study was to assess the efficacy of lipid emulsion as antidotal

Keywords:
Intravenous lipid therapy, calcium channelblockeroverdose,b-blocker overdose, emergency, poisoning

 therapy in severe calcium channel blocker (CCB) and b-blocker (BB) intoxications. Patients and methods: This is a retrospective study in which we have summarized data of patients who were admitted to a university-based emergency department in a period of 3 years and were given intravenous lipid emulsion (ILE) to manage cardiogenic shock due to CCB and BB overdose. Results: We identified 15 patients who received ILE therapy for CCB and BB toxicity. Hospitaliza- tion durations variated between 3 and 33 days (mean 7.46 ± 7.41 days). Drug exposures included CCBs (n = 8, 53.3%), CCBs and paracetamol (n = 1, 6.6%), and BBs (n = 6, 40%). ILE therapy was effective in 12 patients (80%). Three patients (20%) had resistant hypotension, one of whom pro- gressed to pulmonary edema. Adverse effects of ILE therapy were seen in three patients (20%). Two patients underwent mechanical ventilation. Two patients developed hypoxic ischemic ence- phalopathy, one patient died, and 14 patients (93.3%) were discharged from hospital. Conclusion: There was 93.3% survival in patients receiving ILE for drug-induced cardiovascular collapse. Clinically significant adverse effects were uncommon. We suggest ILE administration for the treatmentofcardiogenicshockduetoCCBandBB overdose. 

Objectives: The objective of this study was to assess the efficacy of lipid emulsion as antidotal therapy in severe calcium channel blocker (CCB) and beta-blocker (BB) intoxications. Patients and methods: This is a retrospective study in which we have summarized data of patients who were admitted to a university-based emergency department in a period of 3 years and were given intravenous lipid emulsion (ILE) to manage cardiogenic shock due to CCB and BB overdose. Results: We identified 15 patients who received ILE therapy for CCB and BB toxicity. Hospitalization durations variated between 3 and 33 days (mean 7.46 perpendicular to 7.41 days). Drug exposures included CCBs (n = 8, 53.3%), CCBs and paracetamol (n = 1, 6.6%), and BBs (n = 6, 40%). ILE therapy was effective in 12 patients (80%). Three patients (20%) had resistant hypotension, one of whom progressed to pulmonary edema. Adverse effects of ILE therapy were seen in three patients (20%). Two patients underwent mechanical ventilation. Two patients developed hypoxic ischemic encephalopathy, one patient died, and 14 patients (93.3%) were discharged from hospital. Conclusion: There was 93.3% survival in patients receiving ILE for drug-induced cardiovascular collapse. Clinically significant adverse effects were uncommon. We suggest ILE administration for the treatment of cardiogenic shock due to CCB and BB overdose.