Acute respiratory distress syndrome following verapamil overdose treated with intravenous lipid emulsion: A rare life-threatening complication

Martin, Claudio; Gonzalez, Hélène; Ruiz, Stéphanie; Ribes, David; Franchitto, Nicolas; Minville, Vincent

doi:10.1016/j.annfar.2014.05.013

Cited by 23 publications

(18 citation statements)

References 7 publications

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“…In contrast, the results for treatment of calcium channel blocker toxicity have been more promising. Many case reports have asserted the usefulness of LRT for calcium channel blocker overdose, including verapamil, 90 , 93 , 144 ‐ 149 diltiazem, 93 , 150 ‐ 153 and amlodipine 136 , 149 , 154 ‐ 156 overdose. Furthermore, in experimental settings, ILE has benefited animals with IV verapamil toxicity 157 .…”

Section: Part Iii: Clinical Futurementioning

confidence: 99%

Past, Present, and Future of Lipid Resuscitation Therapy

Fettiplace

Weinberg

2015

J Parenter Enteral Nutr

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Lipid resuscitation therapy was identified in 1998 as an effective treatment for local anesthetic systemic toxicity in an animal model. Since the original observation, the field has progressed tremendously with successful clinical translation and expansion of use to treatment of other types of drug overdose. Recent work has expanded our understanding of the mechanism of this novel treatment, one that includes both a dynamic scavenging component and direct cardiotonic effect. In this review, we discuss the past, present, and future of lipid resuscitation therapy with a focus on our understanding of the mechanism and directions that the field is moving, both from a clinical and basic research side.

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Section: Part Iii: Clinical Futurementioning

confidence: 99%

Past, Present, and Future of Lipid Resuscitation Therapy

Fettiplace

Weinberg

2015

J Parenter Enteral Nutr

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“…[10][11][12][13] Bucklin et al 10 reported a patient who received 42 mL/kg of lipid emulsion and subsequently had lipemia and hyperamylasia but recovered and was discharged. Martin et al 13 reported a patient who received 3,220 mL over 4 hours (0.2 mL/kg/min) and developed acute respiratory distress syndrome, possibly related to intravenous lipid emulsion, which involved additional hospitalization before recovery.…”

mentioning

confidence: 99%

Confusion About Infusion: Rational Volume Limits for Intravenous Lipid Emulsion During Treatment of Oral Overdoses

Fettiplace

Akpa

Rubinstein

et al. 2015

Annals of Emergency Medicine

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“…ARDS was reported in few cases as a complication of ILE [7,11,12]. Suggested mechanisms include hypoperfusion, hypoxic injury from pulmonary vasoconstriction, and effects from resultant localized alveolar edema [13].…”

Section: Discussionmentioning

confidence: 99%

“…Only one case report of ECMO used for ILE-induced ARDS was published [11], the procedure was veno-arterial ECMO, not veno-venous.…”

Section: Introductionmentioning

confidence: 99%

Acute Respiratory Distress Syndrome Associated with Intravenous Lipid Emulsion Therapy for Verapamil Toxicity, Successfully Treated with Veno-Venous ECMO

Friedman¹,

Feld²,

Adler³

et al. 2017

J Dev Drugs

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Calcium channel blocker (CCB) overdose is a potentially fatal poisoning. The use of intravenous lipid emulsion (ILE) therapy for CCB poisoning has emerged in the past few years. In 2017, the American College of Medical Toxicology published interim guidance for the use of ILE resuscitation in these cases. We report an uncommon complication of ILE, acute respiratory distress syndrome, treated with veno-venous extracorporeal membrane oxygenation (ECMO).Case report: A 40-year-old hypertensive woman presented with shock (blood pressure 62/34 mmHg, pulse 86/ min) following ingestion of 4,800 mg verapamil slow release and 1,500 mcg clonidine during a suicide attempt. She was treated with calcium gluconate, sodium bicarbonate, IV high dose insulin, IV glucagon, cardiac amines and vasopressors without response (blood pressure 69/37 mmHg, pulse 78/min). ILE was initiated, and two hours later, she developed acute respiratory failure necessitating intubation and mechanical ventilation. Due to poor oxygenation (pO 2 44 mmHg; FiO 2 100%) emergent veno-venous ECMO was instituted. After one hour her blood pressure increased to 104/50 mmHg (pulse 80, pO 2 75 mmHg), and continued so until weaning from ECMO and ventilation. Conclusion:Acute respiratory distress syndrome can be a major life threating complication following ILE; venovenous ECMO is suggested for its treatment.

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Acute respiratory distress syndrome following verapamil overdose treated with intravenous lipid emulsion: A rare life-threatening complication

Cited by 23 publications

References 7 publications

Past, Present, and Future of Lipid Resuscitation Therapy

Past, Present, and Future of Lipid Resuscitation Therapy

Confusion About Infusion: Rational Volume Limits for Intravenous Lipid Emulsion During Treatment of Oral Overdoses

Acute Respiratory Distress Syndrome Associated with Intravenous Lipid Emulsion Therapy for Verapamil Toxicity, Successfully Treated with Veno-Venous ECMO

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