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Postgrad Med. 2015 Mar;127(2):119-24. doi: 10.1080/00325481.2015.1012480. Epub 2015 Feb 14.

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

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1
Cukurova University, School of Medicine, Emergency Medicine , Adana , Turkey.

Abstract

OBJECTIVES:

The objective of this study was to assess the efficacy of lipid emulsion as antidotal therapy in severe calcium channel blocker (CCB) and β-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 ± 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.

KEYWORDS:

Intravenous lipid therapy; calcium channel blocker overdose; emergency, poisoning; β-blocker overdose

PMID:
25684131
DOI:
10.1080/00325481.2015.1012480
[Indexed for MEDLINE]

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