Central ECMO cannulation for severe dihydropyridine calcium channel blocker overdose.
ECMO (extracorporeal membrane oxygenation)
Pediatric
Peripheral vascular disease
Pharmacology
Shock
cardiovascular
Journal
The journal of extra-corporeal technology
ISSN: 0022-1058
Titre abrégé: J Extra Corpor Technol
Pays: France
ID NLM: 0267637
Informations de publication
Date de publication:
Dec 2023
Dec 2023
Historique:
received:
14
08
2023
accepted:
05
10
2023
medline:
15
12
2023
pubmed:
15
12
2023
entrez:
15
12
2023
Statut:
ppublish
Résumé
Calcium channel blocker (CCB) toxicity carries a high mortality and is the sixth most fatal drug class reported to US poison centers. Amlodipine overdose is characterized by a life-threatening arterial vasodilation that compromises organ perfusion. The management of CCB intoxication is focused on maintaining adequate organ perfusion. In cases refractory to medical therapies, hemodynamic support with extracorporeal membrane oxygenation (ECMO) is warranted necessitating higher flows than usual to compensate for the vasodilation and requiring central cannulation. We present a case of a 12-year-old with severe dihydropyridine CCB ingestion, refractory to medical management and successfully treated with central ECMO cannulation. The patient was discharged home with no significant disability. Central ECMO cannulation may be helpful to facilitate adequate flows in vasodilatory shock such as CCB overdose.
Identifiants
pubmed: 38099637
doi: 10.1051/ject/2023037
pii: ject230039
doi:
Types de publication
Case Reports
Langues
eng
Pagination
206-208Informations de copyright
© The Author(s), published by EDP Sciences, 2023.
Références
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St-Onge M, Dube PA, Gosselin S, et al., Treatment for calcium channel blocker poisoning: a systematic review. Clin Toxicol. 2014;52:926–944. https://doi.org/10.3109/15563650.2014.965827.
Daubin C, Lehoux P, Ivascau C, et al., Extracorporeal life support in severe drug intoxication: A retrospective cohort study of seventeen cases. Crit Care. 2009;13:R138. https://doi.org/10.1186/cc8017.
MacLaren G, Butt W, Best D, et al., Extracorporeal membrane oxygenation for refractory septic shock in children: One institution’s experience. Pediatr Crit Care Med. 2007;8:447–451. https://doi.org/10.1097/01.pcc.0000282155.25974.8f.